Modular health care information management system utilizing reusable software objects

ABSTRACT

A health care information management system that utilizes modular and reusable software objects to allow for user configuration. The disclosed information management system allows for the creation by the user of software objects representative of specific events and resources which will occur or be utilized during the provision of health care to patients. These user configured software modules then allow the user to track the provision of health care, the utilization of resources during the provision of health care, the allocation of resources to perform medical procedures and identify opportunities for enhancing efficiencies in the provision of health care services. In one embodiment of the invention described, the system allows for the user to create, manage and maintain software modules representing specific procedural pathways to be performed in a health care institution. The user creates these modules using user configurable software objects that function to represent containers, resources and data. The software objects are modular and re-usable and allow the user to select components for creation of the modules. The created modules may then be used to provide information management relating to the provision of the medical procedures represented by the procedural pathway modules.

This application is a continuation in part of application Ser. No.08/965,788, filed Nov. 7, 1997, entitled Modular Health-Care InformationManagement System Utilizing Reusable Software Objects, which issued onNov. 30, 1999 as U.S. Pat. No. 5,995,937.

FIELD OF THE INVENTION

This invention relates to the field of information systems for use inthe health care environment and in particular to an information systemincorporating software for supply, scheduling and resource utilizationmanagement in the health care environment. This specification includes amicrofiche appendix of 50 slides with a capacity of 96 frames each, witha total of 1,450 frames. This application is a continuation in part ofapplication 08/965,788, filed Nov. 7, 1997, entitled Modular Health-CareInformation Management System Utilizing Reusable Software Objects, whichissued on Nov. 30, 1999 as U.S. Pat. 5,995,937.

BACKGROUND OF THE INVENTION

One important consideration in the provision of health care is theallocation, utilization and consumption of resources such as labor,durable equipment, reusable supplies and disposable supplies. Forexample, one way for supplies to be obtained by hospitals is for acentral supply service to order the individual supplies anticipated tobe needed for a given time period. These supplies are maintained in asupply room until needed for a given procedure. Once a procedure isscheduled, a pick list (a list of supplies) is generated. A hospitalemployee then uses the pick list to withdraw the desired items frominventory and place them in the operating room where the procedure takesplace. After the procedure is completed, unused supplies are returned toinventory, a list of used supplies is provided to the billingdepartment, and the used supplies are disposed of or re-sterilized.However, this system is costly and inefficient.

For example, a relatively large inventory of supplies has to bemaintained, particularly for standard items such as drapes, sponges,sutures, clamps, etc., which could be used in a large variety ofprocedures. The inventory of such items has to be large in order toinsure that sufficient quantities are on hand for every procedure.Furthermore, the act of picking items for surgery and, later, restockingunused items, is onerous and expensive since relatively highly skilledlabor is utilized to insure that the proper items were collected andthat the restocked items are placed in the proper location. Inparticular, the restocking of unused items is a substantial burden onthe hospital. Each item pulled from inventory has to be either used andbilled for, or restocked and not billed for. If an item is not usedduring the procedure and is billed for anyway, the billing for thatproduct could be considered fraud on the reimburser. Since items areoften individually wrapped, the restocking procedure could be very timeconsuming, particularly where sufficient quantities of items are pickedfrom inventory to cover any situation during surgery. For example, it isnot uncommon to withdraw ten clamps from inventory and use only three orfour, except in situations where heavy bleeding is encountered, whichmight necessitate the use of all ten.

What is needed, therefore, is an integrated information system for usein healthcare institutions for managing, optimizing and analyzing theuse of resources within that institution.

SUMMARY OF THE INVENTION

The above and further objects are met in the exemplar embodiment of thepresent invention, having an information management system for managinginformation relating to providing health care services, including ageneral purpose computer system having storage means for storing datacorresponding to the information, processing means for processingmanagement instructions, display means for visually presenting theinformation, and input means for receiving the management instructionsand the information. Information management software is installed on thegeneral purpose computer system, which software includes softwareobjects, where each of the software objects provides a health careinformation management function and corresponds to an aspect ofproviding health care services.

In various preferred embodiments the software objects include softwareobjects of many different types. Node software objects are for creating,altering characteristics of, and the management of the software objects.Container software objects are for containing the software objects, andcorrespond to at least one of health care procedures, health careinformation, and health care resource groups. Types of containersoftware objects include care event container software objects forcontaining the software objects, and which correspond to health careprocedures, and bundle container software objects to contain thesoftware objects, which correspond to health care resource groups.

Resource software objects correspond to resources to be used in theprovision of health care services, and also are of several types.Equipment resource software objects correspond to equipment to be usedin the provision of health care services. Personnel resource softwareobjects correspond to personnel to be used in the provision of healthcare services, and supply resource software objects correspond tosupplies to be used in the provision of health care services. Finally,data software objects correspond to health care information associatedwith the provision of health care services.

The node software objects, container software objects, resource softwareobjects, and data software objects may be combined in differentstructures, including procedural pathways corresponding to sets ofhealth care procedures, cases corresponding to sets of health careprocedures designated for a patient, and libraries. The cases may beselectively designated as open, corresponding to health care proceduresthat are planned for a patient, or selectively designated as closed,corresponding to health care procedures that are completed for apatient. The libraries may be of predefined care event containerscorresponding to predefined health care procedures, or predefined bundlecontainers corresponding to predefined health care resource groups, or acombination of the two. Libraries can also include predefined datasoftware objects, corresponding to the predetermined sets of health careinformation to be gathered and recorded.

Further, the node software objects, container software objects, resourcesoftware objects, and data software objects may be combined in a libraryof procedural pathways having predefined care event containerscorresponding to predefined health care procedures and predefined bundlecontainers corresponding to predefined health care resource groups,which procedural pathways correspond to predefined sets of health careprocedures. The procedural pathways may contain data objects,corresponding to health care information to be gathered and recorded.The data objects may be used to selectively include a portion of thepredefined bundle containers.

The node software objects, container software objects, resource softwareobjects, and data software objects may be provided in a hierarchicalform, corresponding to a sequential order of health care procedures tobe performed, health care resources to be provided, and health careinformation to be gathered and recorded.

In an alternate embodiment of a system for managing health careservices, a computing means has input means for receiving patient healthcare information, storage means for storing data corresponding to thepatient health care information, processing means for processingsoftware objects corresponding to health care services managementinstructions and the patient health care information and producinghealth care services management output, and display means for visuallypresenting the health care services output.

The software objects include data software objects, resource softwareobjects, and node software objects. The data software objects have meansfor receiving the patient health care information and means forproviding the patient health care information through a standardizedinterface.

The resource software objects associate resources with informationrelating to the resources, and are of several different types. Personnelresource software objects have means for associating a health carepersonnel resource with information relating to the health carepersonnel resource, including at least one of a personnel resourcebilling rate, a personnel resource pay rate, and a personnel resourcetime requirement, and means for providing the information relating tothe health care personnel resource through the standardized interface.

Equipment resource software objects have means for associating a healthcare equipment resource with information relating to the health careequipment resource, including at least one of an equipment resourcebilling rate, an equipment resource cost, and an equipment resource timerequirement, and means for providing the information relating to thehealth care equipment resource through the standardized interface.

Supply resource software objects include bundle supply resource softwareobjects and conditional bundle supply resource software objects. Thebundle supply resource software objects have means for associatinghealth care supply resources with information relating to health caresupply resources, including at least one of a supply resource billingrate and a supply resource cost, and means for providing the informationrelating to heath care supply resources through the standardizedinterface. The conditional bundle supply resource software objects havemeans for associating health care supply resources with informationrelating to health care supply resources, including at least one ofsupply resource billing rates and supply resource costs, and means forselectively providing the information relating to health care supplyresources through the standardized interface based at least in part onthe patient health care information provided by at least one of the datasoftware objects.

The node software objects include at least a pathway node softwareobject having means for selectively creating the data software objectsand means for selectively creating the resource software objects. Meansselectively link the standardized interface of the data software objectsand resource software objects into configurable procedural pathwaysassociated with health care treatment plans. Means also selectivelyadapt the information provided through the standardized interface of thedata software objects, and resource software objects. Means furtherprovide the data software objects and resource software objects with afirst set of functions specifically adapted to the pathway node softwareobject.

In a preferred embodiment, container software objects are also included,having means for selectively associating groups of data softwareobjects, resource software objects, and container software objects, andmeans for associating the groups with information relating to at leastone of a health care procedure and a health care resource kit.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing embodiments of the present invention may be bestunderstood with reference to the following Detailed Description of thePreferred Embodiments and the drawings, wherein:

FIG. 1 is a block diagram showing the generic form of the presentinvention;

FIG. 2 is a tree diagram showing the organization of a preferred form ofthe present invention, and

FIGS. 3-147 are screen shots of a computer program of an exemplarembodiment of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

DeRoyal Industries, Inc., the assignee of U.S. patent application Ser.No. 08/846,798, filed Apr. 30, 1997, entitled, Method and System for theTracking and Profiling of Supply Usage in a Health Care Environment,U.S. patent application Ser. No. 08/936,780, filed Sep. 24, 1997,entitled Method for the Analysis and Standardization of Bills ofResources, and U.S. application Ser. No. 08/889,948, filed Jul. 10,1997, entitled Method for the Supply of Medical Supplies to a Healthcare Institution Based on a Nested Bill of Materials on a ProcedureLevel, which is a continuation-in-part of U.S. Pat. No. 5,682,728,issued Nov. 4, 1997, entitled Method for the Supply of Medical Suppliesto a Health care Institution Based on a Nested Bill of Materials on aProcedure Level, the entire disclosures of which are hereby incorporatedby reference thereto as if fully set forth herein, has been developing aresource utilization paradigm based upon the concept of the proceduralpathway.

In the provision of medical services, the process by which medicalservices are provided may be described as a procedural pathway. Anygiven treatment regimen or clinical procedure may be easily described asa related series of care events. Each care event has some relation to atleast one of either the preceding or the following care events that islogical and reasonable. For example, take a simple procedure such assuturing a wound. The task of suturing a wound can be described as aseries of care events: 1) examination of the wound; 2) cleansing of thewound; 3) anesthesia; 4) suturing of the wound; and 5) dressing thesutured wound. Thus, each of these related care events make up aprocedural pathway for the procedure of suturing a wound. Each of thecare events could be broken down into a more detailed series of sub careevents, thus, the concept of the procedural pathway is scaleable; thatis, any given care event may be made of a series of care events and cantherefore be described as a procedural pathway.

The concept of the procedural pathway may also be expanded to moreinvolved procedures. For example, a patient might go to her doctorcomplaining of particular symptoms. The doctor might then make anexamination or order tests. Based upon the result of the examination ortests, the doctor makes a diagnosis and prescribes a treatment regimen.The treatment regimen may include a surgical procedure to be performedin a hospital, as well as follow up care. In this case, the proceduralpathway might look like: 1) patient induction (basic administrationgetting the patient into the doctor's system); 2) examination; 3)testing; 4) diagnosis; 5) prescription of treatment; 6) admission to thehospital; 7) pre-surgical testing; 8) pre-operative preparation; 9)anesthesia; 10) surgery; 11) post operative recovery; 12) discharge fromhospital; 13) follow up treatment; 14) final discharge. Once again, eachcare event in the given example might be further broken down intosmaller incremental care events, and thus represent a procedural pathwayof its own. For example, the surgery could be broken down into each stepassociated with the surgery from the initial incision until the incisionis closed.

Each care event represents the provision of some type of medical (oradministrative) service, and each care event may also require theallocation of some type of resources in order to be performed. Theseresources may be in the form of labor (doctor, nurse, technician, dataclerk, etc.), equipment (x-ray machine, respirator, vital signsmonitors, etc.), or supplies (sponges, surgical instruments, drapes,x-ray film, sutures, medications, etc.). Thus, for each care event it ispossible to identify the allocation of resources necessary forcompletion of the care event. For example, for the examination stepdescribed in the second example, the allocation of resources could be:15 minutes of doctor's time, use of a specimen collector, use of aspecimen container, and the use of a blood collection kit. Likewise, thetesting step might include the use of an imaging device (such as anx-ray or MRI machine), thirty minutes of technician's time, use of x-rayfilm, use of an x-ray developer and associated chemical supplies, andfifteen minutes of a radiologist's time to interpret the images.

By describing events in the context of a procedural pathway, a frameworkis provided which allows for the systematic classification of the stepsnecessary to treat a particular patient as well as identifying theresource allocation necessary to properly complete the proceduralpathway.

Basing an information system around the procedural pathway, as opposedto just tying services, supplies and other resources used to thepatient, with no real relation to the pathway, provides an inherentability to use the information more efficiently and to allow for greatercost accountability in the provision of medical services.

To illustrate the efficiency of the procedural pathway, it is best toanalyze generally a hospital stay for a given patient. Initially, thepatient will be admitted, have some blood work done, be assigned a room,possibly be subject to some diagnostic screenings, possibly have asurgical procedure done, spend a period of time recovering from theprocedure and be discharged. Also, the procedural pathway may extendbeyond the hospital stay and include follow up care such as periodiccheck ups or rehabilitation. Each step along the procedural pathway canbe broken down into increasingly fine detail as series of more and moredetailed sub procedures. For example, the surgical procedure can befurther broken down into surgical preparation, anesthesia, the surgicalprocedure itself, closing and post operative anesthesia recovery. Eachof these sub procedures could be further broken down into specific tasksto be performed at each stage.

As can be seen from the procedural pathway model, each stage of theprocedural pathway is going to require the utilization of resources.These resources may be labor resources, consumable supply items, durableequipment, reusable supply items, particular rooms (i.e. patient rooms,OR's, recovery rooms, etc.) or services. For example, the blood workwill require a technician to draw the blood, the disposable equipmentfor drawing blood, a labor resource to deliver the blood to thelaboratory, the consumable and reusable supplies for handling andtesting the blood, durable medical equipment for testing the blood,labor resources for testing the blood and generating the report, and alabor resource for providing the report to the patient's chart. As canbe seen, each resource can be analyzed and tied to a particular careevent along the procedural pathway.

Each procedural pathway is going to have some unique characteristicswhich will vary based upon the reason the patient is in the health carefacility (the type of procedure), the doctor performing the procedureand the characteristics of the patient. The procedural pathway ispreferably different for someone having heart bypass surgery fromsomeone having out patient orthopedic surgery. Likewise, preferencesvary from one doctor to another in performing the same surgery; i.e. onedoctor may prefer the feel of one brand of scalpel while another doctormay prefer another. Finally, the patient will often dictate variationwithin a given procedure; i.e. one patient may have certain physicalcharacteristics that require using certain supplies and equipment andanother patient may require different supplies and equipment.

The present invention provides an information system for use in thehealth care environment that utilizes the procedural pathway paradigmfor the input of data, the organization of data, the retrieval of dataand the analysis of the data. In addition to storing unique data foreach procedural pathway (historical data), the present invention alsoprovides for the development of procedural pathways for certain medicalprocedures which have been analyzed and standard pathways developed.These procedural pathways, which are created from modular softwareobjects configured by the user of the software associate the anticipatedresource allocation to a given procedure and allow for the anticipationof resource consumption for each upcoming standard procedure.

For example, if a procedural pathway is developed for a hip replacementsurgery, the procedural pathway for a given patient coming in for hipsurgery is easily developed from the template. The information systemuser merely enters the identifying information about the patient and thesurgeon performing the procedure, and the standard template generates aprocedural pathway showing the resources required for that patient. At afurther level of detail, departure points from the standard template canbe identified and the alternate resource allocation for the departurepoints may also be provided in the information system.

For example, in co-pending application Ser. No. 08/846,798, thedisclosure of which has been incorporated by reference, this feature isdescribed as a conditional bundle. For example, in the hip replacementsurgery described above, variations in resource requirements may varyfrom doctor to doctor because of differing techniques, requirements andsubjective preferences. Thus, the standard template for a hipreplacement surgery may be substantially the same for two differentdoctors, but vary on a few items. The conditional bundles can be used toaccount for the departure from the standard template for each doctorand, by entering the doctor performing the procedure, the informationsystem can automatically associate the appropriate conditional bundlewith the standard template to form the procedural pathway for a givenpatient.

In terms of resource management, there are two basic types of resourceswhich will be needed to perform a medical procedure at a givenlocation: 1) those resources which will need to be brought in fromoutside the location for the procedure and 2) those resources which aremaintained by the location and which must be scheduled for a givenprocedure (for the purposes of this application, although doctors arenot usually employed by the hospital, we will assume that they areresources associated with the location, since they are typically drivingthe scheduling of a procedure at a location). The management of outsideand inside resources requires the consideration of two different sets ofproblems. Typically, the outside resources will primarily include thesupplies which must be ordered from outside vendors, be delivered to thelocation and be provided at the appropriate time and place for theperformance of the procedure. The inside resources will include thelabor resources, equipment owned and maintained by the location andfacilities at the location such as OR's, radiology, laboratories, etc.

In managing the outside resources there are two competing interests, thedesire to have sufficient quantities of everything readily available,which necessitates a large inventory of supplies along with skilledpersonnel to maintain the inventory and deliver it for performance ofthe procedure, and the desire to minimize inventory, which minimizesinventory carrying costs, the risk that inventory will expire beforeuse, tied up capital and the skilled labor necessary to maintain theinventory and pull it for each procedure.

In managing inside resources the goal is to maximize the utilization ofeach available resource while carrying only the minimum amount ofrequired resources to get the job done. Management of these resourcesnecessitates that efficient resource allocation tools be used so thatthe location is not carrying costs associated with labor, equipment andfacilities which are not being fully used, while insuring that all ofthe procedures can be performed in a timely fashion. For example, idleemployees, equipment, OR's, etc. all carry a substantial cost. However,overworked employees, overused equipment and overbooked facilitiesreduce the efficiency and efficacy of the performance of the proceduresand result in additional costs. Thus, precise scheduling and resourceutilization management software is necessary to allow for the maximumproductivity from resources, while minimizing inefficiency caused byoverbooked resources and overworked employees. Additionally, softwarewhich allows for the detailed analysis of historical resourceutilization will allow for the prediction of when new labor and otherresources will be needed and allow for the most effective way ofacquiring those resources, often saving money as opposed to the lastminute recognition and rush acquisition of such resources.

Description of the Preferred Embodiment

In the preferred embodiment, the information management system consistsof a series of software objects implemented using Microsoft ActiveXcontrols which may be configured and linked by a user to build a customconfigured health care information management system. Preferably, theinformation system is implemented on a Windows NT or Windows 95 basedpersonal computer, which may or may not be networked. In order tomaintain a database of information related to this information system, adatabase program such as Microsoft SQL/Server or Microsoft Access isused in background. The information system of the preferred embodimentgenerates data and communicates through an interface compatible with thebackground database program. Typically, the software objects which willbe described are coded in Visual C++ or Visual Basic, and adhere to theframework of ActiveX or OLE controls so as to maintain the ability to beimplemented as compatible software objects in a component based softwarearchitecture.

In general, the software provides a number of “nodes,” each of whichcorrespond to a particular function of the information system. Forexample, if the system will have functions for developing andmaintaining software based procedural pathways, maintaining and loggingresource consumption on a case by case basis, and studying resourceconsumption for logged cases, each of these functions represent onenode. Each of these nodes uses the feature of ActiveX controls to allowobjects created in one node to provide necessary information or form thebasis for a new object in another node. The interaction of objects fromone node to another will be described more fully hereinafter.

Referring now to FIG. 1, each node 200, as described, provides for aparticular information management function in the present invention.Also, each node 200 represents a software object which will allow theuser to perform certain functions and tasks relative to the informationsystem function provided for the node 200. In general, the function ofeach node will be to allow the user to generate specific templates, orsoftware object modules 202 which will organize additional softwareobjects into custom configurations representative of the information tobe managed. Under each node 200, the user will have access to furthersoftware objects, by copying from previously generated templates, bycreating the objects or copying them from an object library, in order toaccess the functionality of the node 200.

The software objects available to the user will be of three specifictypes: 1) container objects 204, 2) resource objects 206 and 3) dataobjects 208. Each of these objects represent ActiveX software objectswhich function as miniature software programs to perform a specificfunction. Container objects 204 function as receptacles of other objectsand act to organize the other objects in accordance with the user'sspecifications. Additionally, container objects 204 will be customizedby the input of data from the user based upon what the container object204 is designed to hold, the specific use to which the container objectis subjected by the user and other usage specific data which the userwill provide.

Resource objects 206 are software objects which represent resources tobe utilized in the provision of the health care. Resource objects 206typically represent supplies, or kits of supplies, equipment, personnel,pharmaceuticals, or any other resource which will be utilized during theprovision of health care. Each resource object 206 will be populatedwith data relevant to that object and will communicate that informationas required.

Data objects 208 are software objects which will be used by the user tocollect specific information for use by the template or the informationsystem. For example, it may be necessary to gather certain procedurespecific information at some point in a procedural pathway and a dataobject 208 may be inserted at that point in a module 202 to collect suchdata and make it available to the appropriate software objects.

Use of the software objects is best understood by a general reference toone function of the information system. Referring now to FIG. 2, thefirst node 210 of the software represents the function of generation,modification and maintenance of software templates for proceduralpathways using the objects previously described. This node 210 allowsthe user to create software modules 212, made up of user selectedobjects, which represent in software a health care procedure orprocedural pathway. In general, as described previously, the proceduralpathway will be broken down into a series of related care events,representing discrete sub procedures along the procedural pathway. Usingthe functionality provided by the procedural pathway node 210, the userdevelops a new module 212 by making an appropriate selection from themenu of the software. The user is prompted to input information relevantto the procedural pathway generally, such as the name of the proceduralpathway, any hospital or other codes used to identify the type ofprocedure, doctors who perform that type of procedure, etc.

Once the module 210 is defined and created, the user breaks theprocedure down into a series of care events. For example, if theprocedure is a heart bypass operation, then various care events can beidentified such as 1) anesthesia care event, 2) draping care event and3) the operative care event. Each of these care events is implemented inthe procedural pathway module 212 by the selection or creation of careevent container objects corresponding to each care event 214, 216, and218. These objects require the input of information relevant to the careevent and function as containers for additional container, resource, ordata care events.

Once the care event containers 214, 216 and 218 are created in themodule 212, the user fills out each of the associated care events forthe module. For example, a patient history data object 220 might beassociated with the module 212, which prompts the user to obtain patientspecific data when the procedural pathway is used relative to aparticular patient. Resources are then associated with each care event.

For example, the Anesthesia Care Event container 214 may contain ananesthesia supply bundle container 222, which in turn can containresources such as anesthesia drugs 224 and an airway circuit 226. Otherresources, provided by a resource object, such as an anesthesiologist228 and patient monitor 230, which are related to the anesthesia careevent 214 are also associated with the anesthesia care event 230. In theexample, the anesthesia drugs resource 224 represents a pharmaceuticalresource object, which contains certain information relevant to thespecific drugs to be delivered, while the airway resource 226 representspecific supplies to be used in the anesthesia care event object 214.

These two items, because they will be used together, are combined in asupply bundle container 222 which may be reused for other procedures,which include an anesthesia care event. The anesthesiologist resource228 represents a personnel resource object and will contain informationconcerning the anesthesiologist, including identification, time to beallotted for the procedure and scheduling information. The patientmonitor resource object 230 represents an equipment resource, whichcontains information about its availability and utilization.

This process is repeated until each of the remaining care events 216 and218 for the procedural pathway is completed (a more complete descriptionof a procedural pathway, including examples of multiple care eventswhich have been completed is provided in the Description of an ExemplarEmbodiment below). The user of the information system then has asoftware module 212 configured for the heart bypass procedural pathway,which consists of container, resource and data objects. Each of thesoftware objects encapsulates information particular to that object andcommunicates that information via a standard interface to other softwareobjects as such information is required.

For example, after constructing a particular procedural pathway module,the user might desire to schedule a procedure for a particular patientusing the procedural pathway. By utilizing a node designed to manageinformation for individual cases, the user could select the appropriateprocedural pathway module, which transfers the data from the proceduralpathway module for that procedure into a case module. The case modulethen contains all of the information from the objects from the selectedprocedural pathway module and provides a ready listing of resources tobe utilized in performing the procedure. With this information,schedules of supplies, equipment, etc. could be generated in order tofacilitate the performance of the procedure.

Additionally, as will be described more fully hereinafter, by creating acase module, the user has available the case node functionality whichallows for the tracking of resource utilization in performing theprocedure and creation of a consumption record for use in analyzingresource utilization, generating cost information for cost recovery andallows the user to perform other case node specific functions. Also, tothe extent that objects created in the procedural pathway have utilityfor other procedural pathways, the created objects may be reused todevelop additional procedural pathways.

As will be described in greater detail below, the various types ofobjects are predefined in the overall software system. Container objectsare available to represent care events, supply bundles and conditionalsupply bundles. Each type of container may then be configured by theuser to reflect the particulars of the procedural pathway to berepresented. Care event containers will be configured with specificinformation for each care event in the procedural pathway and willcontain information relevant to that care event. Supply bundles will beprovisioned with supply resource objects and will have informationspecific to that supply bundle contained therein. Conditional supplybundles will be provisioned with supplies and a condition, which willdetermine if that conditional supply bundle will be used; for example, aconditional supply bundle may be developed for a particular surgeon andwill have supplies used only by that surgeon provided therein. Then, ifthe condition is met when a case is scheduled, such as the particularsurgeon is assigned to the case, that conditional bundle willautomatically be added to the list of objects associated with that case.

Similarly, various types of resource objects are provided as standardtemplates for configuration by the user. Examples of such types ofresource objects are supplies, kits (which are pre-packaged groups ofsupplies), equipment, personnel and pharmaceuticals. When configuringresource objects for a procedural pathway, the user selects theappropriate supply type for the resource to be represented and inputsthe prompted information. For example, the user might be able to look upa database of listed supplies and select a particular supply forinclusion in the procedural pathway. Alternatively, the user couldcreate a new supply from scratch by inputting prompted information tocreate a new supply resource object. The type of information varies fromresource type to resource type, but a standard template is provided foreach resource type to prompt the user to input the appropriateinformation for each resource to be added.

Additionally, while the user has the option to create various container,resource and data objects from scratch for use in the informationsystem, the user, to the extent appropriate, can reuse previouslycreated objects. For example, the user might create a library ofstandard pre-configured objects which are frequently re-used in variousprocedural pathways. Thus, when a new pathway is being created, theselibrary objects may be selected for inclusion in the new pathway.Likewise, information concerning a variety of resources may bemaintained in various database systems maintained by a health careinstitution. The supply department may maintain a database of availablesupplies, or dealers may provide databases of available supplies, byproviding standard database program interfaces for these sources ofinformation. Data from these source may then be automatically read intothe present system in order to configure resource software objects foruse therein.

As described, the use of software objects to represent events, bundles,resources and data objects in a health care information managementsystem allows the user to readily create software modules whichrepresent specific health care procedures which are much more functionalthen with traditional health care database systems. Furthermore, themodule object approach to the system makes it more readily customizablefor particular installations. For example, if the standard configurationof any software object is not readily adapted for a particularinstallation, a programmer will not be required to modify a monolithicsource code listing to implement the new configuration. Forcustomization, the user will only have to reconfigure a particularobject. As long as the standardized data interface for the object isretained, there will not need to be any change in configuration in theremaining source code for the system.

Additionally, the use of the software object framework allows for theready implementation of new functionality, without requiring the rewriteof the majority of the code for the system. For example, if a newfunctionality is required, a new functional node may be added which willutilize, to the extent possible, already existing software objects. Oneexample might be to add a scheduling node to the above describedsoftware to allow for the ready scheduling of personnel, equipment,supplies, etc. Most of the scheduling information for any givenprocedure will be available in the procedural pathway module for thatprocedure. Thus, to create a scheduling node, the user creates asoftware object that queries existing objects for data relevant toscheduling and organizes that data in a useful manner. In the context ofthe present invention, such a node could create scheduling objects forvarious resources indicating their utilization schedule (as receivedfrom the object representing such resources) which would automaticallyquery scheduled resources, check their availability and establish acalendar for each. Other functionality could be created by the creationof other nodes.

For example, the functionality of tracking resource utilization in themanner described in application Ser. No. 08/846,798, filed Apr. 30,1997, entitled Method and System for the Tracking and Profiling ofSupply Usage in a Health Care Environment, may be provided as afunctional node software object. In implementing such a node, eachindividual procedural pathway as described in that application may becopied from a procedural pathway constructed as described above withreference to FIG. 2. A further type of node functionality is describedin U.S. patent application Ser. No. 08/936,780, filed Sep. 24, 1997,entitled Method for the Analysis and Standardization of Bills ofResources, which provides from the conversion of case software moduleobjects into models which could then be analyzed for resourceutilization efficiency and the standardization of bills of resource.Furthermore, the output of the node functionality described inapplication Ser. No. 08/936,780, could then be used to create anoptimized procedural pathway under the procedural pathway node describedwith reference to FIG. 2.

The functionality described above is implemented in the Meridian™information management system marketed by DeRoyal Business Systems, 200DeBusk Lane, Powell, Tenn., 37849, which is an affiliate of the assigneehereof, DeRoyal Industries, Inc.

Description of an Exemplar Embodiment

The foregoing functionality may be best described with reference to thefollowing exemplar embodiment. The exemplar embodiment is available asthe Meridian™ software package available from the assignee hereof,DeRoyal Industries, Inc. The software of the exemplar embodiment hereofis preferably run under the Windows 95 or Windows NT operating systemsand interfaces with a SQL compliant database such as MicrosoftSQL/Server or Microsoft Access. Much of the information maintained bythe exemplar embodiment described herein will be maintained in tableswhich are created and managed using the background database software.

Referring now to FIG. 3, there is shown the Meridian™ Browser window250. The Browser window 250 is similar in appearance to the WindowsExplorer window provided in the Windows 95 and Windows NT environmentsand maintains similar functionality. To the left of the window 250 is aNested Tree view 252, which allows the user to see the Meridian™ nodes,depicted as folders, and other objects. In the top right of the window250 is a Second Tree view 254, which provides similar functionality. Theprovision of the dual tree views 252 and 254 is to allow the user tomove items from one location in the tree to another location, using dragand drop, in the event that the two locations are separated by more thanone window's distance (in the instance where the source folder anddestination folder are not both displayed in the same window).Furthermore, this dual tree view allows the user to look at differentitems at the same time. In the lower right hand side of the window 250is the List view 256, which displays the contents of whatever item ishighlighted in the tree view 252 or 254. It should be further noted thatthe mouse functionality of Windows 95 or Windows NT is maintained in theMeridian™ software; that is, the standard features of highlightingselected folders, files or objects, dragging and dropping and rightclicking are retained.

At the top of the Browser window 250 are drop down menus File 258, Edit260, view 262, Log 264, Maintenance 266 and Help 268. The File 258, Edit260, view 262 and Help 268 drop down menus maintain the standardfunctionality of any Windows™ program with some Meridian™ specificfeatures. The remaining drop down menus deal with functions specific tothe exemplar embodiment.

Below the drop down menus is the Meridian™ tool bar 270 which isprovisioned with buttons to allow shortcut implementation of commonfunctions which are also provided in the drop down menus and othermenus. However, the cut 272, copy 274, paste 276 and paste shortcut 278buttons function in the standard Windows™ environment.

In the tree views 252, 254, the top level is the Meridian™/RCL softwareitself 280, under this level are functional nodes relating to variousinformation management functions to be performed by the software. Thenodes shown in this embodiment are Resource Plans 282, Open Cases 284,Closed Cases 286, Standardization Reports 288, Models 290 and Libraries292. Each node represents a different functionality or acts as a folderfor storing various information. Functional nodes (as opposed to merefolders) are provided as software objects. In most cases, the functionof the node software objects is to allow for the creation, managementand maintenance of additional software objects which perform specificinformation management tasks.

Referring now to FIG. 4, the Resource Plans software node 282 ishighlighted and its menu functions activated by a right click of themouse. As shown in FIG. 4, by right clicking on the Resource Plans node282, the Resource Plans menu 294 is activated. The user may then selectone of the menu functions, either New Pathway Folder 296 or New Pathway298, to activate a function. In FIG. 4, the user has selected the NewPathway Folder 296 function, depicted as inverted text.

Referring now to FIG. 5, after the user has selected the New PathwayFolder function 296 of FIG. 4, a Custom Folder window 300 is presented,which allows the user to enter the name for the new pathway folder. Thename of the new folder is entered into the description window 302 andthe user then selects the OK button 304 to finish the creation of thenew folder.

Referring now to FIG. 6, it can be seen that the new Cardiac Proceduresfolder 306 has appeared under the Resource Plans node 282. In FIG. 6,the user has right clicked on the Cardiac Procedures folder 306 andactivated the Resource Plans node menu 294 and has selected the NewPathway function 298, which will allow the user to create a newprocedural pathway module software object.

In FIG. 7, the Create New Resource Plan window 307 has appeared inresponse to the user selection of the New Pathway function 298 describedin FIG. 6. The Create New Resource Plan window 307 prompts the user toinput information concerning the software module to be created. In theItem No. field 308, the user inputs the desired identifying number forthe new pathway (or, alternatively, the software will provide the nextnumber in sequence which has not yet been used). In the Descriptionfield 310, the user types in the desired description for the pathway.Other fields which may be completed are the Date Created field 312 (thedefault date will be the current date) and the Created By field 314.Finally, the Procedure Attributes field 316 is provided which will allowthe user to select standardized procedure codes, such as the AMA IC9code and description, for the procedure to be represented by thepathway.

This function is provided with a database search capability, by theSearch button 318, which allows the user to search a pre-configuredprocedure code database for the appropriate procedure information. TheRemove button 320 allows the user to remove selected procedure codesfrom the Procedure Attributes field 316 if an inappropriate selection ismade. The OK button 322 allows the user to approve the input and exitthe Create New Resource Plan window 307 while saving the information.The Cancel button 324 allows the user to exit the Create New ResourcePlan window 307 without saving the information. The Apply button 326serves to update database records concerning the new pathway uponactivation. In the present case, the user, upon completion of theinformation, selects the OK button 322 to exit the Create Resource Planwindow 307 and return to the Browser window 250.

Once the new procedure is added, an Open Heart icon 328 appears underthe appropriate Cardiac Procedures folder 306 to indicate the new OpenHeart procedural pathway software module as is seen in FIG. 8. In FIG. 8the user has selected the Open Heart icon 328 and right clicked on themouse to call up the Procedural pathway module menu 330, which providesfunctions related to the creation, management and maintenance of thevarious procedural pathway software modules created by the user. In FIG.8 the user has selected the Add function 332 from the Procedural pathwaymodule menu 330, which will allow the user to add items to the OpenHeart procedural pathway 328.

As described previously, using the procedural pathway paradigm, amedical procedure is broken down into a series of related care events.Typically, the user of the present invention first adds the various careevents to the pathway software module and provisions them later. Thefollowing description provides a walk through of how to add various careevent containers to the pathway.

Referring now to FIG. 9, the Maintain Container Resource window 334appears in response to selecting the Add function 332 from theProcedural pathway module menu 330. The Maintain Container Resourcewindow 334 has Header Information 336 which provides the user withinformation specific to the procedural pathway module which is beingmaintained. The remaining portions of the Maintain Container Resourcewindow 334 are devoted to the creation and searching of availablecontainer resources for addition to the procedural pathway module.

In FIG. 10, the user has selected the designation of Containers in theClass field 338 and the designation of Care Event in the Item Type field340, and selected the New function 342 (depicted in FIG. 9). Theseselections cause the Create a Care Event window 344 to appear. TheCreate a Care Event window 344 allows the user to input information intothe Item No. field 346, Description field 348 and select the type of thenew care event to be added to the procedural pathway module in the Typefield 350. As shown in FIG. 11, the user has entered the appropriateinformation into the fields, and by selecting the OK button 352 mayproceed.

After selecting the OK function 352, the user is returned to theMaintain Container Resource window 334, shown in FIG. 12. As can be seenin FIG. 12, the newly created open heart anesthesia care eventinformation is provided in the Item No. field 354 and Description field356. Other user configurable fields, Quantity Consumed field 358 and C/Pfield 360 allow the user to select the number of the selected itemswhich will appear in the component listing. By selecting the Add NewComponent button 362, as depicted in FIG. 13, the Open Heart AnesthesiaCare Event 364 appears in the Component Listing field 366, shown in FIG.14. This process may be repeated as required for new care events toprovision the procedural pathway module.

As seen in FIG. 15, an additional new care event called the Open HeartOperative Care Event may be created in the same manner by selecting theNew button 342 in the Maintain Container Resource window 334 andentering the appropriate information in the Create a Care Event window344. This new care event can then be added to the Open Heart Proceduralpathway 328 as described previously for the open heart anesthesia careevent.

Each created care event is a software object of the container type. Assuch, each care event is a self contained module relating to thespecific care event and is designed to hold additional container,resource and data objects relating to that particular care event. As asoftware object, once created, care events may be re-used whereappropriate. For example, if the user has created a standard anesthesiacare event, and desires to use it in other procedural pathway softwaremodules, it may be selected and used without the step of creating a newcare event. In fact, the user may create libraries of re-usable softwareobjects which allow for the faster and easier creation of new proceduralpathways.

Referring now to FIG. 16, the Browser window 250 shows the Open Heartmodule 328 including the added Open Heart Anesthesia Care Event object364 and Open Heart Operative Care Event object 370 in the Nested Treeview 252. In the Second Tree view 254 the user has selected theLibraries node 292, and the List view 256 shows the items and subfoldersavailable under the Libraries node 292. Shown in the List view 256 aresubfolders for Resources 374 and Containers 376 and the Product CategoryTree 378, which is a hierarchical taxonomy of products classified bytype. In FIG. 17, the Containers folder 376 is expanded to showadditional subfolders of different types of containers: 1) Care Events380, 2) Conditional Bundles 382 and 3) Resource Bundles 384.

In FIG. 18, the Care Events subfolder 380 is expanded to show thepre-configured care event objects which are available. In FIG. 19, theuser has selected the Pre-Operative Care event 386 for addition to theOpen Heart procedural pathway 328. By dragging and dropping using themouse, the user may copy the Pre-Operative Care Event 386 into the OpenHeart procedural pathway 328 where it appears in FIG. 20. This procedurehas allowed the user to select a pre-configured care event softwareobject and add it to a procedural pathway module without requiring thecreation of a new care event from scratch. The library of pre-configuredsoftware objects allows the user to maintain a set of re-usable objectsrepresenting standard items for inclusion in procedural pathways.

In FIG. 21, the user has selected the Open Heart procedural pathway 328and called up the Procedural pathway module menu 330 and selected theResequence function 388. This function allows the user to change theorder of the items shown under the Open Heart procedural pathway 328. Byselecting the Resequence function 388, the user is presented with theResequence Components window 390, shown in FIG. 22. This window 390shows the items under the Open Heart procedural pathway 328 and byselecting the desired care event, such as the Pre-Operative Care Event386, and using the arrow keys to the right of the window 390 the usermay move the selected care event 386 to the desired location, shown inFIG. 23. Once the desired sequence is achieved, the user exits theResequence Components window 390 by selecting the OK button 394. Asshown in the Browser window 250 of FIG. 24, the new care event sequencehas appeared under the Open Heart procedural pathway 328 with thePre-Operative Care Event object 386 appearing first, followed by theOpen Heart Anesthesia Care Event object 364 and the Open Heart OperativeCare Event object 370.

Containers may be added by using the database search functions of theMaintain Container Resource window 334 as well. Shown in FIG. 25, theuser has entered the Maintain Container Resource window 334 aspreviously described. The Maintain Container Resource window 334displays the care events which are added to the Open Heart proceduralpathway 328 in the Component Listing field 366. From the MaintainContainer Resource window 334, the user may search the database relatedto the information system to add components which have already beencreated, by selecting the Query mode button 398. By selecting the classof the object in the Class field 338 and the item type of the object inthe Item Type field 340 the user may search the database for all objectshaving those attributes by selecting the Search button 318. The resultsof the query appear in the Query Results window 400 shown in FIG. 26.

The Query Results window 400 shows all objects which meet the searchcriteria entered into the Maintain Container Resource window 334. Theuser may then highlight a desired object, in this case the PostOperative Care Event 402, in the Query Results window 400, as shown inFIG. 27. The user adds the desired Post Operative Care Event 402 byselecting the Add New Component button 362 as previously described. Asshown in FIG. 28, the newly selected Post Operative Care Event 402 isthen copied to the Open Heart Procedural pathway 328 and shows up in theComponent Listing window 366. As is seen in FIG. 29, the new PostOperative Care Event 402 appears under the Open Heart procedural pathway328.

One of the features of the exemplar embodiment is the fact that each ofthe containers, resources and data software objects, once created, arereusable with other software module objects, or even other functionalnodes. For example, in the previous description, the Pre-Operative CareEvent 386 and the Post Operative Care Event 402 each maintain theircontained information upon addition to the Open Heart Procedural pathway328.

Referring to FIGS. 30 and 31, the Post Operative Care Event 402 isexpanded to show its contents. Unlike the Open Heart Anesthesia CareEvent 364 and the Open Heart Operative Care Event 370, since the PostOperative Care Event 402 is retrieved from the list of pre-configuredcare events 380 in the Second Tree view 254, it has contents that wereadded at the time that this care event was created. Shown in FIG. 30 isan expanded view of the Post Operative Care Event 402 showing itscontents, which include three bundle container objects, the DealerSupply Bundle 408, the Pharmacy Supply Bundle 410 and the Personnelbundle 412. Each of these container objects, as will be described later,are configured by the user to group resource objects, which are commonlyused together.

As shown in FIG. 31, the various bundles 408, 410 and 412 are expandedto show their contents. The Dealer Supply Bundle 408 contains a WarmingBlanket resource object 414, the Pharmacy Supply Bundle 410 contains apharmacy resource object 416, which is a 30 milligram tablet ofPercocet, and the Personnel bundle 412 contains a Post Operative Nursepersonnel resource object 418. The objects that form the content of thePost Operative Care Event 402 all maintain their original contents fromtheir creation by the user, and by copying the care event container tothe Open Heart Procedural pathway object 328, the contents of thecontainer are included as well.

With respect to created care event containers, once the containerobjects are created, the user then populates the containers with othercontainer, resource and data objects related to the particular careevent. Referring now to FIG. 32, the user has selected the Open HeartAnesthesia Care Event object 364 and right clicked to call up the CareEvent Menu 420 and has selected the Add function 422. This function willallow the user to add other objects to the selected care eventcontainer. As is shown in FIG. 33, selecting the Add function 422 fromthe Care Event Menu 420 will provide the user with the MaintainContainer Resource window 334. Previously, this window 334 was describedwith respect to the Open Heart Procedural pathway 328. Since the OpenHeart Anesthesia Care Event object 364 was selected at the time theMaintain Container Resource window 334 was opened, the Open HeartAnesthesia Care Event object 364 information is reflected in the HeaderInformation 336.

In this example of FIG. 33, the user has selected the class type ofContainers in the Class field 338 and the item type of Bundle in theItem Type field 340. The user then selects the New button 342 whichcauses the Create New Bundle window 424 to appear. This window 424allows the user to create a new bundle container object to hold otherrelated objects. In the example, the user provides the item number andthe bundle description in the Item No. field 426 and Description field428, and by selecting the OK button 430 creates the new bundle object.As shown in FIG. 34, the Open Heart Anesthesia Supplies bundle object432 appears in the Component Listing field 366.

Referring now to FIG. 35, once the new Open Heart Anesthesia Suppliesbundle object 432 is created and added to the Open Heart Anesthesia CareEvent container object 364, the new bundle object 432 appears under thecare event object 364 in the Nested Tree view 252 of the Browser window250, By selecting the Open Heart Anesthesia Supplies bundle object 432and right clicking, the user can call up the Bundle Object Menu 434 inorder to maintain the bundle object 432. In the example of FIG. 35, theuser selects the Add function 436, which allows the user to maintain thecontents of the Open Heart Anesthesia Supplies bundle object 432.Selecting the Add function 436 calls up the Maintain Container Resourcewindow 334, with the Header Information 336 reflecting the maintenanceof the Open Heart Anesthesia Supplies bundle object 432, as shown in theDescription field 348, as depicted in FIG. 36.

The user may then proceed with provisioning the bundle object 432 withresource objects relating to the provision of anesthesia in the openheart procedure. In the example of FIG. 36, the user has selected theclass of objects as resources in the Class field 338 and the item typeof equipment in the Item Type field 340. By selecting the Query modebutton 398 and selecting the Search button 318 the user retrieves a listof all previously created equipment resource objects, which allows theuser to utilize pre-configured equipment resource objects in the OpenHeart Anesthesia Supplies bundle object 432.

FIG. 37 shows the results of the database search in the Query Resultswindow 400. By selecting the desired equipment object, in this case aGeneral Anesthesia Unit 438, the relevant information will appear in theItem No. field 354 and Description field 356 in the Maintain ContainerResource window 334. By then selecting the Add New Component button 362the General Anesthesia Unit object 438 will appear in the ComponentListing field 366, as shown in FIG. 38.

Referring now to FIG. 39 the addition of other objects to the Open HeartAnesthesia supplies bundle container object 432 will be described. InFIG. 39 the Item Type field 340 and the supplies object type areselected. Clicking on the New button 342 brings up the supply objectDefault Information window 440, as depicted in FIG. 40. In this window440 the desired supply object can be called up by either entering anexisting supply object item number in the Item Number field 442, orentering an existing supply object description in the Description field444. Alternately, a new item number is entered or automatically assignedin the Item Number field 442, and the name of a new supply object isentered into the Description field 444. In the example depicted in FIG.40, the new supply object is given the name of “Anesthesia Prep Kit,”which is entered into the Description field 444.

The information management system of the exemplar embodimentautomatically prompts the user for all of the information necessary anddesirable to fully specify the new supply object. The windows to providethis information are invoked by the user by pressing the Next button446, which causes the display of the Inventory Information window 448,as depicted in FIG. 41. The item number and description of the supplyobject are automatically carried forward from the Default Informationwindow 440, depicted in FIG. 40, to the Inventory Information window448, depicted in FIG. 41, and are displayed within the persistent ItemNumber field 442 and Description field 444.

The management information system user may enter specific inventorymanagement information about the supply object using the InventoryInformation window 448. For example, a patient charge number and catalognumber may be entered, as well as other information that may benecessary for the proper tracking of the supply object. The InventoryInformation window 448 also displays other information about the supplyobject, which information cannot be edited by the user at this point.However, if the information is already entered, it is displayed in theInventory Information window 448. When the desired user editableinformation has been entered into the Inventory Information window 448,the user proceeds by pressing the Next button 450.

FIG. 42 depicts the Secondary Information window 452, in which furtherinformation about the supply object is entered. For example, a shortdescription of the supply object may be entered. If the supply objecthas a shelf life, the inactive date of the supply object may also beentered. Other inventory tracking information, such as storage location,cost center, department, site, and other information may also beentered. When the user has entered all of the desired information intothe Secondary Information window 452, the data entry process for thesupply object is resumed by pressing the Next button 454.

The next step of data entry for the supply object in the exemplarembodiment is depicted in FIG. 43, in which the Hospital Cost Historywindow 456 is displayed. In this window, information as to the cost tothe hospital of purchasing the supply object is entered. When thisinformation has been entered, the user continues the data entry processfor the supply object by pressing the Next button 458, which brings upthe Patient Cost History window 460, as depicted in FIG. 44. In thiswindow, information as to the cost to the patient of purchasing thesupply object is entered. Thus, by using the data entered on these twowindows, the user is able to track the cost of specific supply objectsused in the various procedures developed and specify at what cost thesupply objects will be billed out to the patients who use them.

Data entry for the supply object is completed by pressing the Finishbutton 462, which redisplays the Default Information window 440, asdepicted in FIG. 45. The Anesthesia Prep Kit supply object is then addedto the Open Heart Anesthesia Supplies Bundle container object 432 bypressing the Finish button 464. The completed Anesthesia Prep Kit supplyobject 466 is displayed in the Component Listing field 366, as depictedin FIG. 46. Returning to the Browser window 250, as depicted in FIG. 47,the two new supply objects 438 and 466 are displayed under the OpenHeart Anesthesia Supplies container object 364.

FIG. 48 depicts the Maintain Container Resource window 334 for the OpenHeart Anesthesia Care Event 364. The Maintain Container Resource window334 has been opened from the Browser window 250 as described severaltimes above, the procedure for which will not be rehearsed at thispoint. The next series of figures depicts the creation of a new bundleobject, which is to be made a part of the Open Heart Anesthesia CareEvent 364. This process is initiated by selecting the Containers classwithin the Class field 338 and the Bundle type within the Item Typefield 340, and pressing the New button 342.

This action causes the display of the Create New Bundle window 424, asdepicted in FIG. 49. As previously described, the Item Number field 426initially contains an automatically assigned item number or,alternately, a new or existing item number can be entered, which willeither create a new bundle object or pull up an existing bundle object,as described above at length. In the example of FIG. 49, theautomatically assigned new item number is displayed in the Item Numberfield 426, and the new bundle object is given the name of “Dr. AndersonOpen Heart” in the Description field 428. Thus, the new bundle object tobe created is a bundle object that is specific to a specific doctor, andmay contain the items which this doctor desires to have for thespecified procedure.

Therefore, the information management system of the exemplar embodimentprovides for the preferences of individual doctors. For example, thesupplies which are common to all doctors may be put into one bundleobject for a given procedure, and then the additional and varyingsupplies that may be requested by various doctors may be provided inadditional bundle objects that are specific to each doctor. Of course,this is just one example of how the information management system adaptsto the particular needs and procedures of a hospital, and the user ofthe information management system may adapt the system according to thevarious methods described above as suits him best.

The newly described bundle object is created by pressing the OK button430, which enters the item number for the bundle object in the ItemNumber field 354 and the name of the bundle object in the Descriptionfield 356 of the Maintain Container Resource window 334, as depicted inFIG. 50. The Add New Component button 362 is pressed as depicted in FIG.51, and the Dr. Anderson Open Heart bundle object 468 is entered intothe Component Listing field 366 of the Maintain Container Resourcewindow 334, as depicted in FIG. 52. By pressing the Close button 469 theuser is returned to the Browser window 250 depicted in FIG. 53, wherethe newly created Dr. Anderson Open Heart bundle object 468 is depictedas an element of the Open Heart Anesthesia Care Event 364 of the OpenHeart procedural pathway 328.

Specific items, such as those required by “Dr. Anderson,” are added tothe Dr. Anderson Open Heart bundle object 468 by right clicking on theDr. Anderson Open Heart bundle object 468, which brings up the Bundlemenu 470, as depicted in FIG. 54. By selecting the Add function 472, theMaintain Container Resource window 334 is displayed, as depicted in FIG.55. Thus, the next series of figures depicts how specific supplies areadded to the bundle object that was created.

In FIG. 56 the Resources class has been entered into the Class field 338and the Supplies item type has been entered into the Item Type field340. Further, the word “Suture” has been entered by the user into theDescription field 348. By depressing the Query Mode button 398, theSearch button 318 is enabled. By then pressing the Search button 318, asearch is activated which will search for all previously existing supplyobjects that contain the word “suture” in their assigned descriptions.

The results of the search are displayed in the Query Results window 400,as depicted in FIG. 57. In this example, the Suture Ethilon 5-0 P-3 BLK474 is selected. This Suture 474 is added to the bundle object bypressing the Add New Component button 362 in the Maintain ContainerResource window 334, which enters the Suture 474 into the ComponentListing field 366, as depicted in FIG. 58. Additional sutures may alsobe selected from the Query Results window 400, such as the SutureEthilon 3/0 PSL NDL 476, which is also added to the Component Listingfield 366 by pressing the Add New Component button 362 as describedabove. The Query Results window 400 is closed by pressing the Closebutton 477, and the two sutures 474 and 476 are displayed in theComponent Listing field 366 as depicted in FIG. 59.

Beginning with FIG. 60, the steps for adding a personnel resource objectto the Open Heart Anesthesia Care Event object 364 are described. Asdescribed above, the Open Heart Anesthesia Care Event object 364 isselected from the Browser window 250, the Care Event menu 420 is invokedby right clicking, the Add function 422 is selected, and the MaintainContainer Resource window 334 is displayed, as depicted in FIG. 60.

The Component Listing field 366 displays the Open Heart AnesthesiaSupplies bundle object 432 and the Dr. Anderson Open Heart supply bundleobject 468 previously created. The Resources class is selected in theClass field 338 and the personnel item type is selected in the Item Typefield 340. By pressing the New button 342, the Default Informationwindow 478 is displayed, as depicted in FIG. 61.

As described above, a new default value for the item number isautomatically presented in the Item Number field 479, and the user mayenter a name for the new personnel resource object in the Descriptionfield 481. In this example, the new personnel resource object is giventhe name of Anesthesia Tech. Other information may also be entered intothe Default Information window 478, such as the amount of time thatshould be scheduled for the anesthesia technician to perform the careevent being defined in the pathway. The entry of information iscontinued by pressing the Next button 480.

FIG. 62 depicts the Inventory Information window 482. As before, theitem number assigned and the description entered are carried alongthrough the various windows in the Item Number field 479 and theDescription field 481, respectively. In the Inventory Information window482, additional information relative to the proper and orderly inventorymanagement of the described personnel resource is entered, such as apatient charge number and a catalog number. The entry of information iscontinued by pressing the Next button 484.

FIG. 63 depicts the Secondary Information window 486, in which otherinformation relative to the personnel object being defined is entered.The information entry process is continued by pressing the Next button488, which displays the Hospital Cost History window 490, as depicted inFIG. 64. In this window, information relative to the cost to thehospital of the personnel resource object is entered. Pressing the Nextbutton 492 continues the data entry process.

The Patient Cost History window 494 is next displayed, as depicted inFIG. 65. As described above, the Patient Cost History window 494 allowsthe information management system user to enter information about thepersonnel resource object relative to the billing rate of the resourceor, in other words, the amount that the hospital will charge the patientfor the consumed resource.

The data entry process is completed by pressing the Finish button 496,which returns the user to the Default Information window 478, depictedin FIG. 66. Pressing the Finish button 498 returns the user to theMaintain Container Resource window 334, as depicted in FIG. 67. In theMaintain Container Resource window 334, the newly created AnesthesiaTech personnel resource object 500 is now listed in the ComponentListing field 366. Pressing the Close button 502 returns the user to theBrowser window 250.

Beginning with FIG. 68, methods of adding objects that have already beendefined to container objects are described. In a first method of addingpredefined objects, the Query button 506 on the Tool Bar 270 is pressed,bringing up the Query window 504. The Query window 504 is used toinitiate searches on predefined objects located within the Librariesfolder 292.

As depicted in FIG. 69, the query operation can be restricted in avariety of different ways. For example, typing a specific item numberinto the Item field 516 will search for a specific item number. Inaddition, the Query Operators 518 are used in association with the itemnumber typed into the Item field 516, or any of the other fieldsmentioned below, to enable greater flexibility in the query operation.For example, the wildcard character “%” is used to represent any valuethat is within the position where the wildcard character is placed.Thus, performing a query on the item number 12345% finds item numbers123450-123459. The wildcard character can be placed in other positionswithin the item number as well, and can also be placed in multiplepositions within a single item number. Other Query Operators 518 includea Greater Than operator “>” that returns all item numbers greater thanthe item number entered, and a Less Than operator “<” that returns allitem numbers less than the item number entered.

The query operation can also be restricted by the description of theobject, which is entered in the Description field 514, the class of theobject, which is entered in the Class field 508, or the type of theobject, which is entered in the Type field 510. As mentioned above, theQuery Operators 518 are used in conjunction with any or all of thesefields. In addition, query restrictions may be entered within several ofthe fields described, providing a wide breadth of ability to finelyrestrict the query operation to just those objects desired.

In the example depicted in FIG. 69, two query criteria have been enteredinto the Query window 504. The class of the objects for which the queryis being performed is restricted to the resources class by selectingResources from the drop down menu within the Class field 508. Inaddition, the type of the objects for which the query is being performedis restricted to the personnel class by selecting Personnel from thedrop down menu within the Type field 510. When the desired querycriteria have been entered, the query operation is initiated by pressingthe Query button 512.

FIG. 70 depicts the Query Results window 520, from which two objects,the Scrub Nurse personnel resource object 522 and the Circulating Nursepersonnel resource object 524, are selected as depicted in FIG. 71.Pressing the OK button 526 confirms the addition of the selected objectsto the container object previously selected in the Nested Tree view 252.By pressing the OK button 526, the Referenced Item window 528 isinvoked, as depicted in FIG. 72, and the user is given the opportunityto add the selected objects as either custom or standard objects to thepreviously selected container object.

By pressing the Yes button 530, the selected objects are added asstandard objects to the container. When added in this manner, anychanges made to the general template for the selected objects will bereflected in the objects as they reside within the container to whichthey have been added. By pressing the No button 532, the selectedobjects are added as custom objects to the container. When added in thismanner, any changes made to the general template for the selectedobjects will not be reflected in the objects as they reside within thecontainer to which they have been added. By pressing the Cancel button534, the operation of adding the selected objects to the container iscancelled.

In the example depicted in FIG. 72, the Yes button 530 of the ReferencedItem window 528 is pressed, which causes the display of the Enter InQuantity window 536, as depicted in FIG. 73. In the Enter In Quantitywindow 536, the user is presented with the opportunity to indicate thequantity desired for the specific object to be added to the container.In the example depicted in FIG. 73, the first object to be added to thecontainer is a personnel resource object, thus, the quantity to bedesignated is the number of minutes for which the person indicated bythe personnel resource object will be required for the operative careevent container object. A value is entered by the user into the Quantityfield 538, and the Close button 540 is pressed.

In the current example, because two objects have been selected foraddition to the container, pressing the Close button 540 invokes asecond occurrence of the Enter In Quantity window 536, and the user ispresented with an opportunity to enter the desired quantity for thesecond object in the Quantity field 538, as depicted in FIG. 74.Pressing the Close button 540 again accepts the added object with thedesigned quantity. If a third object had been selected for addition tothe container, then a third occurrence of the Enter In Quantity window536 is invoked. Thus, the number of Enter In Quantity windows 536invoked is preferably equal to the number of objects selected foraddition to the container. FIG. 75 depicts the previously selected OpenHeart Operative Care Event container object 370 with the newly addedScrub Nurse personnel resource object 522 and Circulating Nursepersonnel resource object 524.

Beginning with FIG. 75, a second method of adding previously definedobjects to a container object is described. In this example, newresource objects are added to the Open Heart Operative Care Eventcontainer object 370. This second method is commenced by opening theResources folder 374 in the Second Tree view 254 of the Browser window250. The Resources folder 374 contains different types of predefinedresources, which in the example depicted in FIG. 75 include Supplies542, Personnel 544, Equipment 546, and Pharmacy/Medications 548. All ofthese different resource types are preferably contained within folders.

In FIG. 76, the Supplies folder 542 has been selected and opened,revealing the various supply resource objects located within the folder.These supply resource objects are displayed both in a hierarchical treeview within the Second Tree view 254, and in a list view within the Listview 256. The desired supply resource object depicted in the Second Treeview 254 to be added to the container object depicted in the Nested Treeview 252 is selected. In the example depicted in FIG. 77, the desiredsupply resource object is a COBE Oxygenator 550. The List view 256depicts the contents of the previously selected container object, whichin this example is the Open Heart Operative Care Event container object370. Thus, the List view 256 depicts the Scrub Nurse personnel resourceobject 522 and the Circulating Nurse personnel resource object 524 thatwere previously added to the Open Heart Operative Care Event containerobject 370.

The COBE Oxygenator supply resource object 550 is copied from the SecondTree view 254 to the Nested Tree view 252 by dragging it with the mouseto the Open Heart Operative Care Event container object 370, anddropping it there. Upon doing so, the Referenced Item window 528appears, previously described during the recitation of the first methodfor adding predefined objects to a container, and the user is given theopportunity to add the selected object as either a custom or a standardobject to the previously selected container object, as depicted in FIG.78.

By pressing the Yes button 530, the selected object is added as astandard object to the container. When added in this manner, any changesmade to the general template for the selected object will be reflectedin the object as it resides within the container to which it has beenadded. By pressing the No button 532, the selected object is added as acustom object to the container. When added in this manner, any changesmade to the general template for the selected object will not bereflected in the object as it resides within the container to which ithas been added. By pressing the Cancel button 534, the operation ofadding the selected object to the container is cancelled.

In the example depicted in FIG. 78, the Yes button 530 of the ReferencedItem window 528 is pressed, which causes the display of the Enter InQuantity window 536, as depicted in FIG. 79, and as previouslydescribed. In the Enter In Quantity window 536, the user is presentedwith the opportunity to indicate the quantity desired for the specificobject to be added to the container. In the example depicted in FIG. 79,the object to be added to the container is a supplies resource object,thus, the quantity to be designated is the number of the items indicatedby the supplies resource object that are required for the operative careevent container object. A value is entered by the user into the Quantityfield 538, and the Close button 540 is pressed.

In the current example, because only one object has been selected foraddition to the container, pressing the Close button 540 does not invokea second occurrence of the Enter In Quantity window 536. However, aspreviously described, the number of Enter In Quantity windows 536invoked is preferably equal to the number of objects selected foraddition to the container. FIG. 80 depicts the previously selected OpenHeart Operative Care Event container object 370 with the newly addedCOBE Oxygenator supply resource object 550.

FIG. 80 also depicts how the Nested Tree view 252, the Second Tree view254, and the List view 256 of the Browser window 250 interrelate. TheCOBE Oxygenator supply resource object 550, originally depicted in theSecond Tree view 254, is still depicted in the Second Tree view 254, buthas been additionally copied to the Nested Tree view 252. The objectswithin the Open Heart Operative Care Event container object 370, beingthe Scrub Nurse personnel resource object 522, the Circulating Nursepersonnel resource object 524, and the COBE Oxygenator supply resourceobject 550, are depicted both within the Nested Tree view 252 and theList view 256. In this exemplar embodiment, the Nested Tree view 252 andthe Second Tree view 254 display identical hierarchical lists that canbe independently expanded, contracted, and accessed.

Beginning with FIG. 81, a method for adding a personnel resource objectto the Open Heart Operative Care Event container object 370 isdescribed. The container object to which the resource object is to beadded is selected in the Nested Tree view 252, and then the appropriatefolder for the resource object is selected in the Second Tree view 254.In the example depicted in FIG. 81, the appropriate folder is thePersonnel folder 544. Opening the Personnel folder 544 displays thevarious predefined personnel objects within the Personnel folder 544, asdepicted in FIG. 82. The predefined personnel objects within thePersonnel folder 544 are depicted in a hierarchical tree form in theSecond Tree view 254 and in a list form in the List view 256.

The personnel resource object to be added to the previously selectedcontainer object is selected in the Second Tree view 254. In the exampledepicted in FIG. 82, the selected object is the Scrub Technicianpersonnel resource object 552, which is dragged with the mouse anddropped onto the Open Heart Operative Care Event container object 370 inthe Nested Tree view 252. As previously described, this action brings upthe Referenced Item window 528, previously described, and the user isgiven the opportunity to add the selected object as either a custom or astandard object to the previously selected container object, as depictedin FIG. 83.

By pressing the Yes button 530, the selected object is added as astandard object to the container. When added in this manner, any changesmade to the general template for the selected object will be reflectedin the object as it resides within the container to which it has beenadded. By pressing the No button 532, the selected object is added as acustom object to the container. When added in this manner, any changesmade to the general template for the selected object will not bereflected in the object as it resides within the container to which ithas been added. By pressing the Cancel button 534, the operation ofadding the selected object to the container is cancelled.

In the example depicted in FIG. 83, the Yes button 530 of the ReferencedItem window 528 is pressed, which causes the display of the Enter InQuantity window 536, as depicted in FIG. 84, and as previouslydescribed. In the Enter In Quantity window 536, the user is presentedwith the opportunity to indicate the quantity desired for the specificobject to be added to the container. In the example depicted in FIG. 84,the object to be added to the container is a personnel resource object,thus, the quantity to be designated is the amount of time from theperson indicated by the personnel resource object that is required forthe operative care event container object. A value is entered by theuser into the Quantity field 538, and the Close button 540 is pressed.As depicted in FIG. 85, the newly added Scrub Technician personnelresource object 552 is depicted under the Open Heart Operative CareEvent container object 370 in the Nested Tree view 252 of the Browserwindow 250.

Beginning with FIG. 85, a method for adding an equipment resource objectto the Open Heart Operative Care Event container object 370 isdescribed. The container object to which the resource object is to beadded is selected in the Nested Tree view 252, and then the appropriatefolder for the resource object is selected in the Second Tree view 254.In the example depicted in FIG. 85, the appropriate folder is theEquipment folder 546. Opening the Equipment folder 546 displays thevarious predefined equipment objects within the Equipment folder 546, asdepicted in FIG. 85. The predefined equipment objects within theEquipment folder 546 are depicted in a hierarchical tree form in theSecond Tree view 254 and in a list form in the List view 256.

The equipment resource object to be added to the previously selectedcontainer object is selected in the Second Tree view 254. In the exampledepicted in FIG. 86, the selected object is the Pulse Oximetry Unitequipment resource object 554, which is dragged with the mouse anddropped onto the Open Heart Operative Care Event container object 370 inthe Nested Tree view 252. As previously described, this action brings upthe Referenced Item window 528, previously described, and the user isgiven the opportunity to add the selected object as either a custom or astandard object to the previously selected container object, as depictedin FIG. 87.

By pressing the Yes button 530, the selected object is added as astandard object to the container. When added in this manner, any changesmade to the general template for the selected object will be reflectedin the object as it resides within the container to which it has beenadded. By pressing the No button 532, the selected object is added as acustom object to the container. When added in this manner, any changesmade to the general template for the selected object will not bereflected in the object as it resides within the container to which ithas been added. By pressing the Cancel button 534, the operation ofadding the selected object to the container is cancelled.

In the example depicted in FIG. 87, the Yes button 530 of the ReferencedItem window 528 is pressed, which causes the display of the Enter InQuantity window 536, as depicted in FIG. 88, and as previouslydescribed. In the Enter In Quantity window 536, the user is presentedwith the opportunity to indicate the quantity desired for the specificobject to be added to the container. In the example depicted in FIG. 88,the object to be added to the container is an equipment resource object,thus, the quantity to be designated is the amount of time on theequipment indicated by the equipment resource object that is requiredfor the operative care event container object. A value is entered by theuser into the Quantity field 538, and the Close button 540 is pressed.The newly added Pulse Oximetry equipment resource object 554 is depictedunder the Open Heart Operative Care Event container object 370 in theNested Tree view 252 of the Browser window 250, as depicted in FIG. 89.

Beginning with FIG. 90, a method for adding a pharmacy/medicationresource object to the Open Heart Operative Care Event container object370 is described. The container object to which the resource object isto be added is selected in the Nested Tree view 252, and then theappropriate folder for the resource object is selected in the SecondTree view 254. In the example depicted in FIG. 90, the appropriatefolder is the Pharmacy/Medications folder 548. Opening thePharmacy/Medications folder 548 displays the various predefinedequipment objects within the Pharmacy/Medications folder 548, asdepicted in FIG. 90. The predefined objects within thePharmacy/Medications folder 548 are depicted in a hierarchical tree formin the Second Tree view 254 and in a list form in the List view 256, andinclude the Anesthetic Agents folder 556, the Antibiotics folder 558,and the Pain Medications folder 560.

Opening the Pain Medications folder 560 in the Second Tree view 254displays the additional objects located within that folder. In theexample depicted in FIG. 91, these additional items include Fentanyl562, Lortab 564, Morphine 566, and Percocet 568.

The pharmacy/medication resource object to be added to the previouslyselected container object is selected in the Second Tree view 254. Inthe example depicted in FIG. 92, the selected object is the Morphine(IV) pain medication pharmacy/medication resource object 566, which isdragged with the mouse and dropped onto the Open Heart Operative CareEvent container object 370 in the Nested Tree view 252. As previouslydescribed, this action brings up the Referenced Item window 528, and theuser is given the opportunity to add the selected object as either acustom or a standard object to the previously selected container object,as depicted in FIG. 93.

By pressing the Yes button 530, the selected object is added as astandard object to the container. When added in this manner, any changesmade to the general template for the selected object will be reflectedin the object as it resides within the container to which it has beenadded. By pressing the No button 532, the selected object is added as acustom object to the container. When added in this manner, any changesmade to the general template for the selected object will not bereflected in the object as it resides within the container to which ithas been added. By pressing the Cancel button 534, the operation ofadding the selected object to the container is cancelled.

In the example depicted in FIG. 93, the Yes button 530 of the ReferencedItem window 528 is pressed, which causes the display of the Enter InQuantity window 536, as depicted in FIG. 94, and as previouslydescribed. In the Enter In Quantity window 536, the user is presentedwith the opportunity to indicate the quantity desired for the specificobject to be added to the container. In the example depicted in FIG. 94,the object to be added to the container is a pharmacy/medicationresource object, thus, the quantity to be designated is the amount ofmedication indicated by the pharmacy/medication resource object that isrequired for the operative care event container object. A value isentered by the user into the Quantity field 538, and the Close button540 is pressed. The newly added Morphine (IV) pain medicationpharmacy/medication resource object 566 is depicted under the Open HeartOperative Care Event container object 370 in the Nested Tree view 252 ofthe Browser window 250, as depicted in FIG. 95.

Beginning with FIG. 96, a method for adding an object from the ProductCategory Tree 378 to the Open Heart Operative Care Event containerobject 370 is described. The Product Category Tree 378 is a specialcontainer object, or folder, that contains a special selection ofobjects. In the example next explained, the Product Category Tree 378contains predefined objects representing items that are available fromDeRoyal Industries, Inc. Thus, the Product Category Tree 378 isrepresentative of other special collections that could be available,such as product catalogs of other vendors.

The container object to which the product category tree object is to beadded is selected in the Nested Tree view 252, and then the appropriatefolder is selected in the Second Tree view 254. Opening the ProductCategory Tree folder 378 displays the items inside of the ProductCategory Tree folder 378, which in the example depicted in FIG. 97 is aselection of additional container objects, including the Blades &Scalpels folder 570. Opening the Blades & Scalpels folder 570 displaysthe various predefined equipment objects within the Blades & Scalpelsfolder 570, as depicted in FIG. 98. The predefined blades & scalpelsobjects within the Blades & Scalpels folder 570 are depicted in ahierarchical tree form in the Second Tree view 254 and in a list form inthe List view 256, as depicted in FIG. 98, and include the SpecialtyBlades & Scalpels folder 572. It is noted that these items are alsofolders, or in other words container objects, which themselves holdadditional objects.

As depicted in FIG. 99, opening the Specialty Blades & Scalpels folder572 in the Second Tree view 254 displays the additional objects locatedwithin that folder. In the example depicted in FIG. 99, these additionalitems include more container objects, including the Debakey Bladesfolder 574. The Debakey Blades folder 574 is selected and opened in FIG.100, displaying additional container objects within the Debakey Bladesfolder 574, including the 8 mm container object 576. The 8 mm containerobject 576 is selected and opened as depicted in FIG. 101, displayingthe Bld, Debakey, 8 mm Width supply resource object 578 located withinthe 8 mm container object 576.

The supply resource object to be added to the previously selectedcontainer object is selected in the Second Tree view 254. In the exampledepicted in FIG. 102, the selected object is the Bld, Debakey, 8 mmWidth supply resource object 578, which is dragged with the mouse anddropped onto the Open Heart Operative Care Event container object 370 inthe Nested Tree view 252. As previously described, this action brings upthe Referenced Item window 528, and the user is given the opportunity toadd the selected object as either a custom or a standard object to thepreviously selected container object, as depicted in FIG. 103.

By pressing the Yes button 530, the selected object is added as astandard object to the container. When added in this manner, any changesmade to the general template for the selected object will be reflectedin the object as it resides within the container to which it has beenadded. By pressing the No button 532, the selected object is added as acustom object to the container. When added in this manner, any changesmade to the general template for the selected object will not bereflected in the object as it resides within the container to which ithas been added. By pressing the Cancel button 534, the operation ofadding the selected object to the container is cancelled.

In the example depicted in FIG. 103, the Yes button 530 of theReferenced Item window 528 is pressed, which causes the display of theEnter In Quantity window 536, as depicted in FIG. 104, and as previouslydescribed. In the Enter In Quantity window 536, the user is presentedwith the opportunity to indicate the quantity desired for the specificobject to be added to the container. In the example depicted in FIG.104, the object to be added to the container is a supply resourceobject, thus, the quantity to be designated is the number of itemsindicated by the supply resource object that is required for theoperative care event container object. A value is entered by the userinto the Quantity field 538, and the Close button 540 is pressed. Thenewly added Bld, Debakey, 8 mm Width supply resource object 578 isdepicted under the Open Heart Operative Care Event container object 370in the Nested Tree view 252 of the Browser window 250, as depicted inFIG. 105.

The discussion above has briefly described some of the aspects ofcreating and working with procedural pathways. As a part of thisdiscussion, the creation of different types of container objects hasbeen described, including care event container objects and bundlecontainer objects. In addition, the creation and maintenance of resourceobjects has been described, including supply resource objects, personnelresource objects, and equipment resource objects. Further, the nestingof these objects, one within another, has also been briefly described.

A third type of object, a data object, is depicted in FIG. 106. In thisexample, Inter-Operative Data Collection data object 580 is selected inthe Second Tree view 254 of the Browser window 250. The Inter-OperativeData Collection data object 580 is representative of other data objects,which are not depicted in the figures. Data objects are used to holdinformation, such as may be necessary for the completion of a proceduralpathway, or gathered during the performance of a procedural pathway.

For example, when a patient is admitted to the hospital, a data objectcould be created for the patient's demographic and clinical information.This data object could be a part of the admitting procedural pathwaycontainer object. As a part of the performance of the proceduralpathway, a nurse, doctor, technician, or staff member could request orotherwise gather information from the patient and enter it into themanagement system. The information stored within the data object can beused to select various options within the current or later proceduralpathways.

For example, the reason for admittance, such as a specific type of hipsurgery, can be stored in the data object and used to select the correctprocedural pathway for hip surgery. The patient's sex, also stored inthe data object, can select the appropriate type of catheter, a supplyresource object, in a bundle container object. The patient's height andweight can select the appropriate medication in a similar manner.Further, the designation of the patient's doctor, stored within the dataobject, can select the appropriate bundle container object specific tothe designated physician. Thus, the data objects provide the managementsystem with the ability to optionally select conditional branchingroutes within the various available procedural pathways, as well as witha location to store the data taken during the performance of thoseprocedural pathways.

Commencing with FIG. 107, we turn aside from the description of creatingpathways, and move now towards a description of the various ways inwhich the pathways can be used. In FIG. 107, the Open Heart Operativecare event 370 is selected in the Nested Tree view 252 and theProcedural pathway Module menu 330 is invoked, such as by right clickingon the Open Heart Operative care event 370. FIG. 108 depicts theselection of the New function 582, which invokes the New submenu 584.Selecting the Case function 586 from the New submenu 584 invokes theCreate New Case window 588, as depicted in FIG. 109.

The Create New Case window 588 receives information about a specificcase that will follow the selected procedural pathway, which in thisexample is the Open Heart Operative care event 370. Thus, the Create NewCase window 588 is used to copy the general template of the proceduralpathway to an actual case, wherein the procedural pathway to be followedby an actual patient is charted, and where the procedural pathway asactually performed for the patient is recorded. The Action palette 590allows the case to be logged, such as by selecting the Log Case function592, or scheduled, such as by selecting the Schedule Case function 594.

Logging a case indicates that the patient has already completed theprocedural pathway, the data has been gathered, and the case is beingcreated to provide a record of what has already been accomplished.Scheduling a case indicates that the patient has not yet completed theprocedural pathway, and the case is being created to provide a promptfor the data that needs to be gathered and the supplies, personnel, andequipment that need to be scheduled or consumed. In the example depictedin FIG. 109, the case is being logged after the procedural pathway hasbeen completed, and so the Log Case function 592 is selected.

A case number is assigned to the case, which number is depicted in theCase # field 596. In the example depicted the case number has beenautomatically assigned by the management system. However, in alternateembodiments the user is able to select any case number desired,preferably a case number that has not been assigned to any other case.The patient's physician is selected from the Physician field 598, asdepicted in FIG. 110. The correct physician can be selected in a varietyof ways. For example, as depicted in FIG. 110, the Drop List button 600is selected, invoking an alphabetized list of available physicians.

Alternately, the first few letters of the name of the correct physiciancan be typed into the Physician field 598 prior to or after selectingthe Drop List button, which will cause the list of available physiciansto automatically scroll to a position in the alphabetized listcorresponding to the first few letters so typed. Further, the CriteriaSelection button 602 may be selected to display additional selectioncriteria for selecting the appropriate physician. Once the correctphysician has been identified, clicking on the name enters it in thePhysician field 598, as depicted in FIG. 111.

FIG. 111 also depicts the method of selecting the appropriateanesthesiologist in the Anesthesiologist field 604. Preferably, this isdone in the same manner as that used to select the correct physician.Thus, the same options for locating the correct anesthesiologist areavailable, such as invoking the alphabetized list with the Drop Listbutton 600 and displaying additional selection criteria with theCriteria Selection button 602. As before, when the correctanesthesiologist is located, the name is displayed in theAnesthesiologist field 604 by selecting it, as depicted in FIG. 112. Theaccount number, associating the patient with this specific case, isentered into the Account field 606, also as depicted in FIG. 112.

Selecting the Criteria Selection button 602 associated with the Patientfield 110 invokes the Patient Master Table window 608, as depicted inFIG. 113. The Patient Master Table window 608 is used to locate thecorrect patient by matching one or more of a variety of identificationinformation, such as medical record number, account number, last name,first name, middle initial, address, city, zip code, state, or otherinformation, as depicted in FIG. 113. In this manner, a variety ofinformation that may be more readily known or remembered about thepatient may be used to select the correct patient. This screen may alsobe used to create a new patient designation that did not existpreviously.

FIG. 114 depicts an alternate method of selecting the correct patient,by typing in the first few letters of the patient's name, as describedabove. As depicted, typing in the first two letters of the patient'sname scrolls the alphabetized list of patient names to the first suchname satisfying the search criteria. In this manner, the user canquickly scroll to the relevant portion of the patient name list, andthereby more readily locate and enter the correct name.

The Description field 612, depicted in FIG. 115, accepts a user defineddescription for the case. However, in many instances it may be better tohave a standardized description for the cases that are created, ratherthan to allow each individual user to enter case descriptions thatconform to the whim of each such user. Thus, the Retrieve StandardDescription button 614 is provided, which operates to parse a selectionof the information that is previously entered into the Create New Casewindow 588, and enter the parsed selection into the Description field612. In this manner, all case descriptions contain a standardizedselection of case information, allowing the cases to be more readilyidentified when using the description of the case. In a most preferredembodiment, the specific parsing and selection of information to be usedas the description is user definable across the management system.

Other information about the case is selectively entered in the OtherCase Attributes field 618. One especially convenient method of enteringsuch information is by pressing the Data Wizard button 616, whichinvokes the Data Wizard window 620, as depicted in FIG. 116. The DataWizard window 620 is preferably configured to allow for the convenientselection of standardized insurance carrier ICD9 codes, which codes theinsurance carriers insist on receiving prior to authorizing payment forservices. Thus, the Data Wizard window 620 presents an alphabetizedscroll list of the ICD9 codes, from which the proper code can beselected and entered into the Other Case Attributes field 618 bypressing the Finish button 498, which procedure has been accomplished asdepicted in FIG. 117.

When the OK button 526 is pressed, signaling the completion of case dataentry in the Create New Case window 588, the Resolve Preferences window622 is invoked, as depicted in FIG. 118. The Resolve Preferences window622 presents the user with the opportunity to selectively indicate oroverride the conditional branching that may otherwise be specified bythe procedural pathway. For example, if the procedural pathway suggeststhat one or more of several bundle container objects may be required forthe procedure, the user is presented with the opportunity to select thedesired bundles from within the Resolve Preferences window 622. Mostpreferably, those preferences which are resolved by data that hasalready been entered in a data object are preselected by the managementsystem and placed within the Selected Bundles field 626. However, allbundles related to the procedural pathway are preferably visible withinthe Available Bundles field 624, so that the user may override theautomated selection made by the management system.

The user transfers bundle objects from the Available Bundles field 624to the Selected Bundles field 626 by clicking on the desired bundle tohighlight it, and then pressing the Add Selected Bundle button 628.Alternately, all bundle objects listed in the Available Bundles field624 may be added to the Selected Bundles field 626 by pressing the AddAll Bundles button 630. When the Add All Bundles button 630 is used, theindividual bundle objects in the Available Bundles field 624 do not needto be highlighted, as all bundle objects will be transferred to theSelected Bundles field 626, whether they are highlighted or not.

Similarly, bundle objects displayed in the Selected Bundles field 626may be transferred back to the Available Bundles field 624 by firstclicking on the bundle object to be so transferred and then pressing theRemove Selected Bundle button 632, which removes the highlighted bundleobject from the Selected Bundles field 626 and places it back within theAvailable Bundles field 624. Alternately, all bundle objects listed inthe Selected Bundles field 626 may be transferred back to the AvailableBundles field 624 by pressing the Remove All bundles button 634. Whenthe Remove All Bundles button 634 is used, the individual bundle objectsin the Selected Bundles field 626 do not need to be highlighted, as allbundle objects will be transferred to the Available Bundles field 624,whether they are highlighted or not. Pressing the Finish button 498signals the management system that all bundle object preferences havebeen resolved and the user is ready to continue.

Upon clicking the Finish button 498, as depicted in FIG. 118, theResource Consumption Log window 636 is invoked, as depicted in FIG. 119.In the Resource Consumption Log window 636, the user is presented withthe opportunity to account for the various resources that were allocatedto the procedural pathway during the bundle object selection justcompleted. The Resource Consumption Log window 636 is preferablypresented at this point only when the case is being logged, or in otherwords, only when the procedural pathway has already been completed andthe actual disposition of the resources is actually known. If the caseis being creating as a scheduled case, then the procedural pathway hasnot as yet been completed, the disposition of the resources is notactually known, and the Resource Consumption Log window 636 isirrelevant at this point in time.

All of the resources allocated to the procedural pathway are depicted ina scrolling list within the Resource Consumption Log window 636. In theexample depicted in FIG. 119, the list of allocated resources is quiteshort, and so there is no need to scroll the display in order to see theentire list. However, in a typical procedural pathway that would be usedin an actual procedure, the list of allocated resources would tend to bemuch more lengthy.

The allocated resources are logged by confirming the actual dispositionof the resources. The management system starts with the basic assumptionthat all of the resources allocated to the procedural pathway have beenconsumed. Thus, for each resource listed in the Description field 638there is an associated value listed in the Consume Value field 640. Thevalue listed in the Consume Value field 640 is a default value that ispreferable equal to the value originally specified as the desiredquantity of the resource when it was originally added to the containerobject.

However, not all of the resources may have been consumed. Some of theresources may have been scrapped, in which case they were notproductively used. For example, the allocated number of resources mayhave been packaged together in a sterile package that, once it wasopened, exposed all of the contents to the environment. Thus, any ofthat package contents that were not productively consumed had to bescrapped, or in other words, just thrown away. This, of course, iswasteful and leads to unnecessary expense, and so is a condition that ispreferably tracked by the management system.

Other resources do not necessarily need to be scrapped if notproductively consumed. In this case, the allocated resource can bereturned to a stocking area, where it can be restaged for use in asubsequent clinical procedure. However, even though the resource itselfis not needlessly destroyed, there is still wasted expense involved withpreparing the resource for the clinical procedure when it was notactually required. Further, there is wasted expense involved withreturning the unnecessary resource to the storage area, and making itavailable for alternate use. Therefore, this situation is also one thatthe management system preferably tracks. In either case, whether theallocated resource is scrapped or returned, the management systempreferably analyzes the data and is able to suggest to the user that theallocated amount of the resource be adjusted to a value more nearlyresembling the actual productive consumption of the resource in theprocedural pathway described.

The disposition of the resource is depicted in FIG. 120, in which anentry in the Consume Value field 640 has been selected and altered. Theoriginal value for the entry, as depicted in FIG. 119, was 4. However,in the example depicted in FIG. 120, only 2 of the items were actuallyproductively consumed, and so this value has been entered in the ConsumeValue field 640. The other two units of the resource, those of the fourallocated that were not consumed, are preferably accounted for. Thus,the user selects the appropriate of either the Scrap Value field 642 orthe Return Value field 644, or both, and enters the appropriate value inthe fields according to the actual disposition of the resources. In theexample depicted in FIG. 121, the Return Value field 644 has beenselected, in which the user may enter the number of units of theresource that have been returned to stores.

When all such corrections to the actual disposition of the severalresources allocated to the procedural pathway have been completed, theuser may next confirm utilization of the allocated personnel resourcesin a manner similar to that described above, by pressing the PersonnelUtilization button 646, which invokes the Logged Information window 648,as depicted in FIG. 122. In the Logged Information window 648 the useris presented with the opportunity to account for the actual amount oftime used of the various personnel that were allocated to the proceduralpathway. The Description field 650 displays the description of the firstpersonnel resource specified in the procedural pathway. The ScheduledTotal field 652 indicates the total number of minutes of personnelresource time that were allocated to the procedure. The Consumed Totalsfield 654 allows the user to enter in the actual amount of time that wasproductively consumed in the course of the procedure.

In the example depicted in FIG. 122, the consumed value equals thescheduled value, indicating that all of the scheduled time wasproductively used. However, the user could also enter a value in theConsumed Total field 654 that is either greater than or less than thevalue displayed in the Scheduled Totals field 652. If the value enteredinto the Consumed Total field 654 is greater than the value displayed inthe Scheduled Totals field 652, then it is an indication that theprocedure demanded a greater amount of time from the personnel resourcethan was initially allocated. Such a situation may create severescheduling problems, if the person represented by the personnel resourcehas another procedure to participate in, and the current procedure istaking longer than originally anticipated. This is a situation that ispreferably tracked by the management system, so that personnel timemanagement and scheduling can be optimized.

Alternately, if the value entered into the Consumed Total field 654 isless than the value displayed in the Scheduled Totals field 652, then itis an indication that the procedure required a lesser amount of timefrom the personnel resource than was initially allocated. Although it ishoped that the excess time not consumed for the procedure was “returned”and productive use was made thereof, it is far more likely that theexcess time was “scrapped.” Therefore, the management system assumesthat the time was lost in an unproductive manner, and there is, in theembodiment depicted, no provision for specifying the actual dispositionof the scheduled time that was not consumed. This too is a situationthat is preferably tracked by the management system, so that personnelresources are used to their fullest, thus reducing the excess expenseassociated with under utilized personnel resources.

When the consumed time for the personnel resource indicated in theDescription field 650 has been entered into the Consumed Totals field654, the Next button 656 is clicked, and the user is brought to a secondinstance of the Logged Information window 648, which represents a secondpersonnel resource, if such has been allocated to the proceduralpathway. Thus, a separate personnel Logged Information window 648 isdepicted for each personnel resource that has been allocated to theprocedural pathway. FIG. 123 depicts the second instance of the LoggedInformation window 648, in which the time actually consumed by the nextpersonnel resource, listed in the Description field 650, is entered intothe Consumed Totals field 654, in a manner the same as that describedabove. When this time has been entered, the Next button 656 is clicked.

In the example depicted, only two personnel resources have beenallocated to the procedural pathway, and so no more personnel LoggedInformation windows 648 are required. Thus, pressing the Next button 656as described above invokes an instance of the Logged Information window648 that displays an equipment resource in the Description field 650, asdepicted in FIG. 124. It is possible to enter the consumed time for thevarious equipment resources directly from the Resource Consumption Logwindow 636, by pressing the Equipment Utilization button 647, asdepicted in FIG. 121. By so doing, the Logged Information windows 648associated with personnel resources may be bypassed. The amount ofallocated time for the equipment resource that was actually consumed isentered in the Consumed Totals field 654, in a manner similar to thatdescribed above, and the Next button 656 is clicked.

Had there been additional equipment resources allocated to theprocedural pathway, then additional instances of the equipment LoggedInformation window 648 would preferably have been invoked. However, inthe example depicted, only one such equipment resource was allocated.Thus, clicking the Next button 656 invokes the Logged Event window 662,as depicted in FIG. 125, in which the total time for the proceduralpathway, as described in the Description field 650, is accounted for.The name of the procedural pathway is depicted in the Description field650, and the user is given the opportunity to add, update, remove, orset the times for the procedure represented by the procedural pathway.

For example, pressing the Add button 664 adds all of the time previouslydescribed in the Logged Information windows 648 described above. Thiscreates an entry in the Logged Event window 662, as depicted in FIG.126. The entry so created by clicking the Add button 664 can be deletedby pressing the Remove button 668. Additionally, the start and stoptimes listed in the entry can be changed by clicking on the Set Timesbutton 670, which preferably invokes a dialog for accomplishing thetask. If all of the allocated time for the personnel resources andequipment resources had been productively consumed, such that noadjustment to the allocated times had been necessary, then the usercould have by passed all of the Logged Information windows 648 describedabove and gone directly to the Logged Event window 662 by pressing theEvent Times button 649, as depicted in FIG. 121.

The event set times are updated with the information specified in theLogged Event window 662 by pressing the Update button 666, which invokesthe Times Manager dialog box 672, as depicted in FIG. 127. The TimesManger dialog box 672 confirms that the times have been updated. Theuser proceeds by clicking the OK button 674, which returns control tothe Logged Event window 662. Clicking the Next button 566 in the LoggedEvent window 662 invokes the Set Care Event Times dialog box 658,depicted in FIG. 128, in which all of the times specified in the aboveprocedures are posted to the management system by pressing the Yesbutton 660.

The new case 676 created by the procedure specified above is placedwithin the Open Cases node 284 in the Nested Tree view 252 of theBrowser window 250, as depicted in FIG. 129. As a preferable default,the new case 676 is given the default description that was specified inthe Description field 612, as depicted in FIG. 115. Cases listed underthe Open Cases node 284 preferably differ from those listed under theClosed Cases node 286 in several respects. As a point of conception,open cases are those that are scheduled but pending, still in progress,or completed but not yet logged. Closed cases are those that have beencompleted and logged. Thus, changes may still be made to an open case,whereas changes cannot be made to a closed case, unless it is reopened.The management system preferably uses only closed cases in its automatedanalysis routines, so as to not base results and conclusions on casesthat have not been fully logged.

Resources allocated to a specific case can be designated as having beenconsumed, scraped, or returned in a quicker manner than the morecomplete logging method described above. This quicker procedure may beused when, for example, only a specific portion of the proceduralpathway of the case has been accomplished, and only the resourcesspecified for that portion of the pathway are to be accounted for. Thisprocedure is initiated by expanding the case 676 in the Nested Tree view252, as depicted in FIG. 130. The case 676 can be expanded in any one ofseveral different ways, such as by selecting the case by clicking on itand then pressing the enter key on the keyboard, double clicking on thecase 676, or clicking on the plus sign next to the name of the case 676.

Once the case 676 has been opened, the resource to be accounted for isselected, as depicted in FIG. 131. In the example of FIG. 131, theAnesthesia Prep Kit supply resource object 466 has been selected, andthe Supply Resource menu has been invoked, such as by right clicking onthe Anesthesia Prep Kit supply resource object 466. It is noted at thispoint that the menu associated with the Anesthesia Prep Kit supplyresource object 466 under the Open Cases node 284 is a different menuthan that associated with the Anesthesia Prep Kit supply resource object466 under the Resource Plans node 282. Thus, even though the AnesthesiaPrep Kit supply resource object 466 has been copied from one node toanother, the management system treats the objects differently accordingto the location of the object, and presents menu options that arecontext sensitive to the location of the object. Selecting the QuickConsume function 680 invokes the Supplies Manager 682, depicted in FIG.132, in which information about the number of units allocated to thecase, and the disposition of the number of units allocated, is depicted.

The number of units allocated, as described in the procedural pathway,is initially displayed in the Consumed field 684. Thus, the managementsystem initially assumes that the scheduled number of units will all beconsumed. If, however, such is not the case, then the user merelychanges the value entered in the Consumed field 684. As soon as thisevent occurs, the Scrapped field 686 and the Returned field 688 becomeactive and editable, as depicted in FIG. 133. Thus, the user can specifythe number of units that are either scrapped or returned. Pressing theOK button 690 completes the procedure and posts the disposition of theresources to the management system.

One of the many tremendous benefits of the management system accordingto the present invention is the ability to extract detailed informationand analysis from the data that is collected from the cases. As anoverview in retrospect, the initial description provided herein was ofcreating procedural pathways within the Resource Plans node 282. Theseprocedural pathways represented standard templates that are used toschedule and allocate the various available resources required tocomplete the procedure represented by the procedural pathway.

After a procedural pathway is constructed, an actual case is copied fromthe procedural pathway to the Open Cases node 284. The actualdisposition of the resources allocated to the case, as based on theprocedural pathway, is specified. Once the disposition of the resourceshas been accomplished, the case can be used in a model to analyze theefficiency of the procedural pathway and the utilization of resources.This analysis procedure is commenced by invoking the Open Case menu 692,as depicted in FIG. 134, such as by right clicking on the new case 676,and selecting the Build Analysis Model function 694, as depicted in FIG.135. A new model 696 is thereby created under the Models node 290, whichnew model 696 is preferably given a standardized name by the managementsystem, as depicted in FIG. 136.

A more descriptive name is given to the new model 696 by invoking theUpdate Description dialog box 698, as depicted in FIG. 137, such as bypressing the F2 key on the keyboard when the new model 696 ishighlighted. The desired description for the new model 696 is enteredinto the Description field 700, and the selection of the new descriptionis posted to the management system by clicking the Close button 702. Therenamed model 696 is depicted in FIG. 138.

FIG. 139 depicts the contents of the model 696, which appear identicalto the contents of the corresponding case 676, on which the model isbased, the contents of which case 676 appear similar to the contents ofthe corresponding procedural pathway 370. However, in reality, thevarious objects which are the contents of the model 696, case 676, andpathway 370 are not identical. One evidence of this is that thecontextual menus for the corresponding objects within the model 696,case 676, and pathway 370 are not the same. Each of the contextual menusprovide a different set of functions, which functions are specificallyrelated to the purpose and character of the objects. Further, while theobjects in one node do correlate and track with their counterpartobjects in other nodes, they contain different types of data, specificto their intended functions. This becomes further evident in thediscussion below, which describes more of the analysis functions of themanagement system.

A discussion of the preferred method of creating a new study, in whichan analysis can be performed, is commenced with reference to FIG. 140.The Standardization Reports node 288 is selected, and theStandardization Reports menu is invoked in one of the methods describedabove. The New Study function 706 is selected from the StandardizationReports menu 704, as depicted in FIG. 141, and a new study 708 iscreated, with a default name as preferably determined by the managementsystem, as depicted in FIG. 142. The new study is given a new name byinvoking the Update Description dialog box 698, as described above,entering the desired new name, and clicking the Close button 702, asdepicted in FIG. 143. The renamed study is displayed as depicted in FIG.144.

The model on which the study is to be based is selected, as depicted inFIG. 145. In the example of FIG. 145, the Anderson Open Heart AnalysisModel 696 is selected for the new Open Heart Study 708. The study iscreated by moving the Open Heart Analysis Model 696 from the Models node290 to the appropriate study 708 within the Standardization Reports node288, as depicted in FIG. 146. Again it is mentioned at this juncture,that although the objects that are copied and moved from one node toanother appear to retain their exact identity and function, this is notthe case. Copying and moving the objects from one node to anothermodifies the object to retain a portion of its prior characteristics,and a link to the prior associated object, but endows the new objectwith additional functionality, as described throughout this discussion.It is this ability to retain specific aspects of the precursor objectwhile accepting aspects of the successor object that allows themanagement system according to the present invention to provide suchpower with such an easily understood interface.

The analysis is commenced by invoking the Analysis menu 710 from theselected model 696 inside of the appropriate study 708, as depicted inFIG. 147. From this menu, the management system of the exemplarembodiment provides the ability for the user to create many differentkinds of reports. For example, reports can be generated which track howwell the resources allocated to a given procedural pathway correlate tothe actual usage of those resources.

The foregoing description of the preferred and exemplar embodiments ofthe present invention is for the purposes of illustration and notlimitation. The preferred and exemplar embodiments are capable ofnumerous modifications, substitutions and deletions without departingfrom the scope of the invention as set forth in the following claims.For example, while the preferred and exemplar embodiments are describedas being implemented in the Windows 95 or Windows NT environment usingActiveX or OLE controls from Microsoft Corp., the modular softwareobject approach described could be implemented in other standards oroperating environments such as Delphi. Furthermore, while the objectsdescribed above are preferentially written in Visual C++, any othercommon programming language may be used as well. Finally, while thecomputer environment is preferentially a PC environment, eithernetworked or stand alone, other computer systems such as RISC servers,workstations, mainframes, or access to processors through the Internetmay be substituted.

What is claimed is:
 1. A system for managing health care services,comprising: a) computing means having; i) input means for receivingpatient health care information, ii) storage means for storing datacorresponding to the patient health care information, iii) processingmeans for processing software objects corresponding to health careservices management instructions and the patient health care informationand producing health care services management output, and iv) displaymeans for visually presenting the health care services output, b) thesoftware objects including data software objects having; i) means forreceiving the patient health care information, and ii) means forproviding the patient health care information through a standardizedinterface, c) the software objects including resource software objectsfor associating resources with information relating to the resources,including; i) personnel resource software objects having; (1) means forassociating a health care personnel resource with information relatingto the health care personnel resource, including at least one of apersonnel resource billing rate, a personnel resource pay rate, and apersonnel resource time requirement, and (2) means for providing theinformation relating to the health care personnel resource through thestandardized interface, ii) equipment resource software objects having;(1) means for associating a health care equipment resource withinformation relating to the health care equipment resource, including atleast one of an equipment resource billing rate, an equipment resourcecost, and an equipment resource time requirement, and (2) means forproviding the information relating to the health care equipment resourcethrough the standardized interface, and iii) supply resource softwareobjects including; (1) bundle supply resource software objects having;(a) means for associating health care supply resources with informationrelating to health care supply resources, including at least one of asupply resource billing rate and a supply resource cost, and (b) meansfor providing the information relating to health care supply resourcesthrough the standardized interface, and (2) conditional bundle supplyresource software objects having; (a) means for associating health caresupply resources with information relating to health care supplyresources, including at least one of supply resource billing rates andsupply resource costs, and (b) means for selectively providing theinformation relating to health care supply resources through thestandardized interface based at least in part on the patient health careinformation provided by at least one of the data software objects, andd) the software objects including node software objects including atleast a pathway node software object having; i) means for selectivelycreating the data software objects, ii) means for selectively creatingthe resource software objects, iii) means for selectively linking thestandardized interface of the data software objects and resourcesoftware objects into configurable procedural pathways associated withhealth care treatment plans, iv) means for selectively adapting theinformation provided through the standardized interface of the datasoftware objects, and resource software objects, and v) means forproviding the data software objects, and resource software objects, witha first set of functions specifically adapted to the pathway nodesoftware object.
 2. The system of claim 1, further comprising containersoftware objects having; a) means for selectively associating groups ofdata software objects, resource software objects, and container softwareobjects, and b) means for associating the groups with informationrelating to at least one of a health care procedure and a health careresource kit.
 3. The system of claim 1, wherein the node softwareobjects further comprise a case node software object having: a) meansfor receiving the procedural pathways from the pathway node softwareobject and converting the procedural pathways into at least one of anopen case software object and a closed case software object, b) meansfor providing open case software objects and closed case softwareobjects to the pathway node software object, c) means for selectivelyadapting the information provided through the standardized interface ofthe data software objects and resource software objects, and d) meansfor providing the data software objects and resource software objectswith a second set of functions specifically adapted to the case nodesoftware object.
 4. The system of claim 1, wherein the node softwareobjects further comprise a model node software object having: a) meansfor receiving the closed case software objects from the case nodesoftware object and converting the closed case software objects intoanalysis model software objects, b) means for providing analysis modelsoftware objects to the case node software object, c) means forselectively adapting the information provided through the standardizedinterface of the data software objects and resource software objects,and d) means for providing the data software objects and resourcesoftware objects with a third set of functions specifically adapted tothe model node software object.
 5. The system of claim 4, wherein thenode software objects further comprise a report node software objecthaving: a) means for receiving the analysis model software objects fromthe model node software object and converting the analysis modelsoftware objects into configurable report software objects b) means forproviding configurable report software objects to the model nodesoftware object, c) means for selectively adapting the informationprovided through the standardized interface of the data software objectsand resource software objects, and d) means for providing the datasoftware objects and resource software objects with a fourth set offunctions specifically adapted to the model node software object.
 6. Thesystem of claim 1, wherein the node software objects further comprise alibrary node software object having; a) means for selectively creatingthe data software objects, b) means for selectively creating theresource software objects, c) means for selectively creating containersoftware objects, d) means for selectively linking the standardizedinterface of the data software objects, resource software objects, andcontainer software objects into configurable sets associated with thehealth care services, e) means for selectively adapting the informationprovided through the standardized interface of the data softwareobjects, resource software objects, and container software objects, andf) means for providing the data software objects, resource softwareobjects, and container software objects with a fifth set of functionsspecifically adapted to the model node software object.
 7. The system ofclaim 1, further comprising means for scheduling health care servicesresources based at least in part on the health care services managementoutput.
 8. The system of claim 1, further comprising means for billingpatients based at least in part on the health care services managementoutput.
 9. The system of claim 1, further comprising means for orderingsupplies based at least in part on the health care services managementoutput.
 10. A system for managing health care services, comprising: a)computing means having; i) input means for receiving health careservices information and health care services management instructions,ii) storage means for storing data corresponding to the health careservices information, iii) processing means for selectively processingcommands corresponding to the health care services managementinstructions based on the health care services information and producinghealth care services management output, and iv) display means forvisually presenting the health care services output, b) data softwareobjects having; i) means for receiving patient health care information,and ii) means for providing the patient health care information througha standardized interface, c) resource software objects for associatingresources with information relating to the resources, including; i)personnel resource software objects having; (1) means for associating ahealth care personnel resource with information relating to the healthcare personnel resource, including at least one of a personnel resourcebilling rate, a personnel resource pay rate, and a personnel resourcetime requirement, and (2) means for providing the information relatingto the health care personnel resource through the standardizedinterface, ii) equipment resource software objects having; (1) means forassociating a health care equipment resource with information relatingto the health care equipment resource, including at least one of anequipment resource billing rate, an equipment resource cost, and anequipment resource time requirement, and (2) means for providing theinformation relating to the health care equipment resource through thestandardized interface, iii) supply resource software objects including;(1) bundle supply resource software objects having; (a) means forassociating health care supply resources with information relating tohealth care supply resources, including at least one of a supplyresource billing rate and a supply resource cost, and (b) means forproviding the information relating to health care supply resourcesthrough the standardized interface, and (2) conditional bundle supplyresource software objects having; (a) means for associating health caresupply resources with information relating to health care supplyresources, including at least one of supply resource billing rates andsupply resource costs, and (b) means for selectively providing theinformation relating to health care supply resources through thestandardized interface based at least in part on the patient health careinformation provided by at least one of the data software objects, andd) container software objects having; i) means for selectivelyassociating groups of data software objects, resource software objects,and container software objects, and ii) means for associating the groupswith information relating to at least one of a health care procedure anda health care resource kit, and e) node software objects including; i) apathway node software object having; (1) means for selectively creatingthe data software objects, (2) means for selectively creating theresource software objects, (3) means for selectively creating thecontainer software objects, (4) means for selectively linking thestandardized interface of the data software objects, resource softwareobjects, and container software objects into configurable proceduralpathways associated with health care treatment plans, (5) means forselectively adapting the information provided through the standardizedinterface of the data software objects, resource software objects, andcontainer software objects, and (6) means for providing the datasoftware objects, resource software objects, and container softwareobjects with a first set of functions specifically adapted to thepathway node software object, ii) a case node software object having;(1) means for receiving the procedural pathways from the pathway nodesoftware object and converting the procedural pathways into at least oneof an open case software object and a closed case software object, (2)means for providing open case software objects and closed case softwareobjects to the pathway node software object, (3) means for selectivelyadapting the information provided through the standardized interface ofthe data software objects, resource software objects, and containersoftware objects, and (4) means for providing the data software objects,resource software objects, and container software objects with a secondset of functions specifically adapted to the case node software object,iii) a model node software object having; (1) means for receiving theclosed case software objects from the case node software object andconverting the closed case software objects into analysis model softwareobjects, (2) means for providing analysis model software objects to thecase node software object, (3) means for selectively adapting theinformation provided through the standardized interface of the datasoftware objects, resource software objects, and container softwareobjects, and (4) means for providing the data software objects, resourcesoftware objects, and container software objects with a third set offunctions specifically adapted to the model node software object, iv) areport node software object having; (1) means for receiving the analysismodel software objects from the model node software object andconverting the analysis model software objects into configurable reportsoftware objects, (2) means for providing configurable report softwareobjects to the model 95 node software object, (3) means for selectivelyadapting the information provided through the standardized interface ofthe data software objects, resource software objects, and containersoftware objects, and (4) means for providing the data software objects,resource software objects, and container software objects with a fourthset of functions specifically adapted to the model node software object,and v) a library node software object having; (1) means for selectivelycreating the data software objects, (2) means for selectively creatingthe resource software objects, (3) means for selectively creating thecontainer software objects, (4) means for selectively linking thestandardized interface of the data software objects, resource softwareobjects, and container software objects into configurable setsassociated with the health care services, (5) means for selectivelyadapting the information provided through the standardized interface ofthe data software objects, resource software objects, and containersoftware objects, and (6) means for providing the data software objects,resource software objects, and container software objects with a fifthset of functions specifically adapted to the model node software object.11. An information management system for managing information relatingto providing health care services, comprising: a) a general purposecomputer system having; i) storage means for storing data correspondingto the information, ii) processing means for processing managementinstructions, iii) display means for visually presenting theinformation, and iv) input means for receiving the managementinstructions and the information; and b) information management softwareinstalled on the general purpose computer system and having softwareobjects, each of the software objects providing a health careinformation management function and corresponding to an aspect ofproviding health care services, wherein the software objects arecombined in procedural pathways corresponding to sets of health careprocedures.
 12. The information management system of claim 11, whereinthe software objects further comprise node software objects forcreating, altering characteristics of, and the management of thesoftware objects.
 13. The information management system of claim 12,wherein the characteristics of the software objects further comprisepredefined options for modifying or manipulating a selected one of thesoftware objects.
 14. The information management system of claim 12,wherein the management of the software objects further comprisesanalyzing health care information associated with a selected one of thesoftware objects.
 15. The information management system of claim 11,wherein the software objects further comprise container software objectsfor containing the software objects, and corresponding to at least oneof health care procedures, health care information, and health careresource groups.
 16. The information management system of claim 15,wherein the container software objects further comprise care eventcontainer software objects for containing the software objects, andcorresponding to health care procedures.
 17. The information managementsystem of claim 15, wherein the container software objects furthercomprise bundle container software objects for containing the softwareobjects, and corresponding to health care resource groups.
 18. Theinformation management system of claim 11, wherein the software objectsfurther comprise resource software objects corresponding to resources tobe used in the provision of health care services.
 19. The informationmanagement system of claim 18, wherein the resource software objectsfurther comprise equipment resource software objects corresponding toequipment to be used in the provision of health care services.
 20. Theinformation management system of claim 18, wherein the resource softwareobjects further comprise personnel resource software objectscorresponding to personnel to be used in the provision of health careservices.
 21. The information management system of claim 18, wherein theresource software objects further comprise supply resource softwareobjects corresponding to supplies to be used in the provision of healthcare services.
 22. The information management system of claim 11,wherein the software objects further comprise data software objectscorresponding to health care information associated with the provisionof health care services.
 23. The information management system of claim11, wherein the software objects further comprise: a) node softwareobjects for creating, altering characteristics of, and managing thesoftware objects, b) container software objects for containing thesoftware objects, and corresponding to at least one of health careprocedures, health care information, and health care resource groups, c)resource software objects corresponding to resources to be used in theprovision of health care services, and d) data software objectscorresponding to health care information.
 24. The information managementsystem of claim 23, wherein the node software objects, containersoftware objects, resource software objects, and data software objectsare combined in cases corresponding to sets of health care proceduresdesignated for a patient.
 25. The information management system of claim24, wherein the cases are selectively designated as open, correspondingto sets of health care procedures that are planned for a patient. 26.The information management system of claim 24, wherein the cases areselectively designated as closed, corresponding to sets of health careprocedures that are completed for a patient.
 27. The informationmanagement system of claim 23, wherein the node software objects,container software objects, resource software objects, and data softwareobjects are combined in a library of predefined care event containerscorresponding to predefined health care procedures.
 28. The informationmanagement system of claim 23, wherein the node software objects,container software objects, resource software objects, and data softwareobjects are combined in a library of predefined bundle containerscorresponding to predefined health care resource groups.
 29. Theinformation management system of claim 23, wherein the node softwareobjects, container software objects, resource software objects, and datasoftware objects are combined in a library of procedural pathways havingpredefined care event containers corresponding to predefined health careprocedures and predefined bundle containers corresponding to predefinedhealth care resource groups, corresponding to predefined sets of healthcare procedures.
 30. The information management system of claim 29,wherein at least a portion of the predefined bundle containers areselectively included based at least in part on the health careinformation in the data software objects.
 31. The information managementsystem of claim 23, wherein at least a portion of the resource softwareobjects are selectively included within a procedural pathway nodesoftware object based at least in part upon user entered information inthe data software objects.
 32. An information management system formanaging information relating to providing health care services,comprising: a) a general purpose computer system having; i) storagemeans for storing data corresponding to the information, ii) processingmeans for processing management instructions, iii) display means forvisually presenting the information, and iv) input means for receivingthe management instructions and the information; and b) informationmanagement software installed on the general purpose computer system andhaving software objects, each of the software objects providing a healthcare information management function and corresponding to an aspect ofproviding health care services, the software objects including; i) nodesoftware objects for creating, altering characteristics of, and managingthe software objects, ii) container software objects for containing thesoftware objects, and corresponding to at least one of health careprocedures, health care information, and health care resource groups,iii) resource software objects corresponding to resources to be used inthe provision of health care services, and iv) data software objectscorresponding to health care information; c) the node software objects,container software objects, resource software objects, and data softwareobjects combined in procedural pathways corresponding to sets of healthcare procedures.
 33. The information management system of claim 32,wherein at least a portion of the resource software objects areselectively combined within the procedural pathways based at least inpart upon user entered information in the data software objects.
 34. Aninformation management system for managing information relating toproviding health care services, comprising: a) a general purposecomputer system having; i) storage means for storing data correspondingto the information, ii) processing means for processing managementinstructions, iii) display means for visually presenting theinformation, and iv) input means for receiving the managementinstructions and the information; and b) information management softwareinstalled on the general purpose computer system and having softwareobjects, each of the software objects providing a health careinformation management function and corresponding to an aspect ofproviding health care services, the software objects including; i) nodesoftware objects for creating, altering characteristics of, and managingthe software objects, ii) container software objects for containing thesoftware objects, and corresponding to at least one of health careprocedures, health care information, and health care resource groups,iii) resource software objects corresponding to resources to be used inthe provision of health care services, and iv) data software objectscorresponding to health care information; and c) the node softwareobjects, container software objects, resource software objects, and datasoftware objects provided in a hierarchical form, corresponding to asequential order of health care procedures to be performed, health careresources to be provided, and health care information to be gathered andrecorded.
 35. The information management system of claim 34, wherein atleast a portion of the resource software objects are selectivelyprovided based at least in part on the health care information recordedwithin the data software objects.
 36. A method for managing health careservices, comprising: a) entering patient health care information into acomputing means with an input means, b) storing data corresponding tothe patient health care information in a storage means, c) processingsoftware objects corresponding to health care services managementinstructions and the patient health care information on a processingmeans, and thereby producing health care services management output withthe processing means, the processing further including; i) selectivelycreating data software objects, equipment resource software objects,personnel resource software objects, bundle supply resource softwareobjects, and conditional bundle supply resource software objects with apathway node software object, ii) receiving the patient health careinformation with the data software object, iii) providing the patienthealth care information through a standardized interface, iv)associating a health care equipment resource with information relatingto the health care equipment resource with the equipment resourcesoftware object, the information relating to the health care equipmentresource including at least one or an equipment resource billing rate,and equipment resource cost, and an equipment resource time requirement,v) providing the information relating to the health care equipmentresource through the standardized interface, vi) associating a healthcare personnel resource with information relating to the health carepersonnel resource with the personnel resource software object, theinformation relating to the health care personnel resource including atleast one of a personnel resource billing rate, a personnel resource payrate, and a personnel resource time requirement, vii)providing theinformation relating to the health care personnel resource through thestandardized interface, viii) associating health care supply resourceswith information relating to health care supply resources with thebundle supply resource software object, the information relating tohealth care supply resources including at least one of a supply resourcebilling rate and a supply resource cost, ix) providing the informationrelating to the health care supply resources through the standardizedinterface, x) associating health care supply resources with informationrelating to health care supply resources with the conditional bundlesupply resource software object, the information relating to health caresupply resources including at least one of supply resource billing ratesand supply resource costs, xi) selectively providing the informationrelating to health care supply resources through the standardizedinterface based at least in part on the patient health care informationprovided by at least one of the data software objects, xii)selectivelylinking the standardized interface of the data software objects,equipment resource software objects, personnel resource softwareobjects, bundle supply resource software objects, and conditional bundlesupply resource software objects with the pathway node software object,xiii) selectively adapting the information provided through thestandardized interface of the data software objects, equipment resourcesoftware objects, personnel resource software objects, bundle supplyresource software objects, and conditional bundle supply resourcesoftware objects with the pathway node software object, and xiv)providing the data software objects, equipment resource softwareobjects, personnel resource software objects, bundle supply resourcesoftware objects, and conditional bundle supply resource softwareobjects with a first set of function specifically adapted to the pathwaynode software object, and d) visually presenting the health careservices output on a display means.